Relationships between quality of life and finding benefits in a diagnosis of colorectal cancer

This longitudinal study investigated relations between benefit‐finding domains and outcome measures. Participants were 1,757 individuals diagnosed with colorectal cancer. A written questionnaire and telephone interview were completed at 5‐months (Time 1) and 12‐months post‐diagnosis (Time 2). Exploratory and confirmatory factor analyses revealed three psychometrically sound factors: personal growth, interpersonal growth, and acceptance. Results of regression analyses were conducted and found that Time 1 benefit‐finding domains accounted for significant amounts of variance in Time 1 positive affect and cancer‐related quality of life (both the aggregate score and its social/family, functional, and colorectal cancer‐specific well‐being subscales). Time 1 personal growth also predicted Time 1 psychological distress. After controlling for Time 1 positive affect, personal growth continued to predict Time 2 positive affect. Results delineate the benefit‐finding domains in the context of colorectal cancer and their differential links with outcome measures cross‐sectionally, and longitudinally. These findings have implications for theory building and the measurement of benefit‐finding.     

Examining adversarial growth in illness: The factor structure of the silver lining questionnaire (SLQ-38)

The Silver Lining Questionnaire (SLQ-38) is purported to measure 10 aspects of adversarial growth in illness. To date however, no empirical evidence exists to support this claim. Hence the aim of this study was to investigate the factor structure of the SLQ-38 in a sample of 560 individuals with multiple sclerosis (MS), cancer, cardiac, and renal disease. The results demonstrate that 24 SLQ-38 items can be factored into five subscales: improved personal relationships, greater appreciation for life, positive influence on others, personal inner strength and changes in life philosophy, all of which are in accordance with the literature on adversarial growth. Individuals with MS experienced lower adversarial growth compared to other illness groups. Gender, age and time since diagnosis were unrelated to adversarial growth in illness. The utility of the revised SLQ-38 is discussed along with suggestions for future research on the convergent and divergent validity of this revised instrument.     

Benefit finding in multiple sclerosis and associations with positive and negative outcomes.

This study examined the direct and stress-buffering effects of benefit finding on positive and negative outcomes. A total of 502 people with multiple sclerosis completed a questionnaire at Time 1 and, 3 months later, at Time 2 (n = 404). Measures of illness were collected at Time 1, and number of problems, stress appraisal, benefit finding, subjective health, and negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) outcomes were measured at Time 2. Factor analyses showed the Benefit Finding scale to have 2 dimensions: Personal Growth and Family Relations Growth. Hierarchical regressions showed that after controlling for the effects of demographics, illness, problems, and appraisal, benefit finding showed strong direct effects on the positive outcomes. Benefit finding did not have a direct effect on distress or subjective health but had a weak association with negative affect. Family Relations Growth had a stress-buffering effect on distress.     

“There's a deeper level of meaning as to what suffering's all about”: experiences of religious and spiritual growth following trauma

Some survivors of trauma report experiencing beneficial changes in self-perception, relationships, and philosophy of life, and positive changes in the realm of existential, spiritual, or religious matters. The purpose of the present study was to examine participants’ phenomenological experiences of spiritual and religious posttraumatic growth (PTG). Transcribed data from semi-structured interviews with 10 women, self-identified as Christian, who had experienced spiritual or religious growth following various trauma were analysed using Interpretative Phenomenological Analysis. Results indicated how religion provided a framework that assisted participants to incorporate life changes, and to find meaning in their suffering. The most salient themes identified in relation to religious and spiritual PTG included: process of spiritual and religious growth, strengthening of religious and spiritual beliefs, and personal and spiritual growth and healing. Participants’ trauma and associated distress prompted a process of questioning and meaning-making that facilitated deeply experienced personal and spiritual growth, and was related to intrinsic religiosity.     

The experience of spirituality in the psycho-social adaptation of cancer survivors

This article presents the results of a retrospective, phenomenological study of the experience of spirituality in the psychosocial adaptation of cancer survivors. The experience of illness for the participants in the study is one which promotes greater personal and spiritual growth. The study demonstrates that illness provokes personal growth and transformation in the individual. While making use of pre-existing coping resources, the person with cancer reevaluates and restructures her or his life, integrating new values, priorities, and perspectives which lead the patient to invest her or his life in something meaningful and beneficial to others.     

The Mediating Effects of Benefit Finding on the Relationship Between the Identity Centrality of Negative Stressful Events and Identity Achievement

Which types of benefit finding in negative events central to identity lead to higher identity achievement? This study examined the relationships between the identity centrality of negative events, benefit finding, and identity achievement, with consideration of differences between benefit-finding domains. Participants included 245 undergraduates, who recalled a previous negative event and completed the Identity Scale, Centrality of Event Scale, and items regarding benefit finding. Path analysis showed that benefit finding regarding personal growth consistently correlated with identity achievement, while the effects of recognizing warmth in others were unstable depending on event category. The findings demonstrated the role of benefit finding regarding personal growth in promoting identity achievement and buffering the original adverse impact of negative events on identity.     

The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: A longitudinal study

Benefit finding is a meaning making construct that has been shown to be related to adjustment in people with MS and their carers. This study investigated the dimensions, stability and potency of benefit finding in predicting adjustment over a 12 month interval using a newly developed Benefit Finding in Multiple Sclerosis Scale (BFiMSS). Usable data from 388 persons with MS and 232 carers was obtained from questionnaires completed at Time 1 and 12 months later (Time 2). Factor analysis of the BFiMSS revealed seven psychometrically sound factors: Compassion/Empathy, Spiritual Growth, Mindfulness, Family Relations Growth, Lifestyle Gains, Personal Growth, New Opportunities. BFiMSS total and factors showed satisfactory internal and retest reliability coefficients, and convergent, criterion and external validity. Results of regression analyses indicated that the Time 1 BFiMSS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (positive states of mind, positive affect, anxiety, depression) after controlling for Time 1 adjustment, and relevant demographic and illness variables. Findings delineate the dimensional structure of benefit finding in MS, the differential links between benefit finding dimensions and adjustment and the temporal unfolding of benefit finding in chronic illness.     

Personal Growth of Mothers of Preterms: Objective Severity of the Event,Subjective Stress,Personal Resources,and Maternal Emotional Support

This prospective study investigated the personal growth of Israeli mothers of premature babies at two medically defined risk levels (infants at low risk, n = 42; infants at moderate-high risk, n = 52), examining the contribution to the five dimensions of personal growth of objective event characteristics (baby’s risk level), perceived levels of mother’s stress (linear and curvilinear associations), and mother’s personal resources (self-esteem, attachment styles, perceived emotional support from her own mother). In addition, the role of the event severity as a moderator of the association between perceived maternal emotional support and personal growth was explored. Findings indicate that mothers in the two risk groups did not differ in level of perceived stress. Mothers of infants at moderate-high risk, however, experienced more spiritual change. In addition, consistent curvilinear associations emerged between perceived levels of stress and personal growth for three dimensions of growth: new possibilities, personal strength, and relations with others (with a similar trend for appreciation of life). Thus, mothers reporting moderate stress levels experienced the highest personal growth. Finally, risk group played a moderating role in the association between perceived maternal emotional support and personal growth on the dimensions of new possibilities, personal strength, and relations with others. On these dimensions, only among mothers of low-risk babies were higher levels of maternal emotional support associated with greater personal growth. The results highlight the importance of the subjective experience and the value of maternal emotional support for the personal growth of mothers of preterms. These findings may help in designing measures to identify populations at risk and developing appropriate interventions, as well as impact on the working procedures and support currently offered in most neonatal intensive care units.     

Benefit Finding and Physical Health: Positive Psychological Changes and Enhanced Allostasis

Many individuals who undergo stressful life events report that they have derived some positive benefit from the experience. Although the majority of research on benefit finding has focused on its psychological correlates, there is intriguing evidence that benefit finding may also have effects on physical health. In this paper, we review the emerging literature on benefit finding and physical health and present an integrative model in which we identify specific psychological and physiological pathways through which benefit finding may influence physical health outcomes. In particular, we consider the hypothesis that benefit finding may involve changes in a number of psychological domains – namely, changes in appraisal and coping processes, relationships, goals and priorities, and positive affect – that lead to a state of enhanced allostasis, buffering against negative effects of catabolic stress responses and promoting activity in restorative physiological systems. Empirical evidence for this model is reviewed, focusing on studies that have examined positive psychological constructs relevant to benefit finding and their effects on stress reactivity, recovery, and habituation, as well as restorative processes.     

“创伤后成长”--理解癌症患者的一个新视角

“创伤后成长”是积极心理学的一个新概念,指个体在与创伤性事件或情境进行抗争后体验到的心理上的正性变化。研究发现癌症患者在经历苦难的同时,也会产生创伤后成长,表现在对新的可能性、与他人关系、生活感恩、个人优势等方面的新感知和精神领域的改变。创伤后成长与患者年龄及心理痛苦水平负相关,与受教育水平、家庭收入、积极应对方式、情绪表达和社会支持正相关。这些结果给临床护理的提示是,重视患者的内在潜能,鼓励患者以积极的应对方式、外化的情绪表达来缓解心理痛苦,通过提供充分的社会支持促进其成长,提高患者抗癌的内在力量。     

Facing mortality: exploring the mechanisms of positive growth and the process of recalibration

Interviews with 11 participants who had suffered a range of traumas five or more years ago were analysed using thematic analysis to explore the impact of a negative event and the mechanisms involved in subsequent changes and adjustment. Participants described a sense of mortality reflected in a feeling that life was fragile as though the intellectual knowledge of their future death had been turned into an emotional reality, which had offered them opportunity to make changes across a number of life domains. For some, however, these changes were hindered through ongoing issues such as physical and psychological symptoms and legal action. The final theme reflected a process of recalibration and many described achieving a state of relative contentment. Transcending these themes were a series of mechanisms facilitating change including downward comparisons to friends and abstract others, active remembering involving forced reflection, self-talk and reading diaries, shifting priorities and a focus on the positives and lowered expectations. Overall, it is suggested that growth following trauma is achieved through a shift in the object of comparison whether it be others or themselves as either in an alternative life trajectory or even death. This may result in a greater appreciation of life, but rather than being achieved through growth in one's sense of self per se it reflects a generalised lowering of expectations and growth in comparison to a new lowered set of points of comparison.     

BEYOND THE BONDAGE OF BOUNDARIES

This narrative seeks to describe a route towards the roots of personal and cultural identity through shared journeys of loss and grief. It attempts to find lived spaces for spiritual growth and reconciliation through the complexity of shared experiences and through the search for ways of transcending the boundaries of cultural identity and culturally prescribed ways of grieving. The complex interplay of these juxtaposing themes and interconnecting tensions and paradoxes provides opportunities for new ways of being and the possibility of transcendence of barriers such as gender, ethnicity, culture, language difference, and social class. This is achieved in consideration of context and environment and through the metaphor of ''pushing out the boundaries of lived experience beyond common understanding.''     

Spiritual coaching in cancer patients: treating the spirit as well as the disease

Interest in the exploration of spirituality in medical practice has been growing recently due to some studies suggesting its role in the improvement of patient well-being and quality of life. This project examined the feasibility of providing spiritual coaching with patients in an outpatient Radiation Oncology clinic setting. The purpose of spiritual coaching was to provide patients with opportunities to explore their current spiritual lives, increase their involvement in spiritually enhancing activities, and expand their spiritual opportunities. Quality-of-life measurements focused on feelings of hopefulness and distress were used in patients undergoing radiation treatment for cancer. This study suggests that there is a potential benefit for spiritual coaching in the care of cancer patients, and future studies will be done to further el ucidate the ationship of spirituality and quality of life in this population.     

Educational Opportunities for Older Adults

This paper challenges congregations to become centers for life-long learning. An experiment in educational programming conducted by Saint Olaf College at residences of the Ebenezer Society in Minneapolis, Minnesota is reported upon. The benefits derived From the program included: (1) growth in understanding of the Christian faith; (2) better understanding of political issues; (3) greater appreciation of the liberal arts; and (4) personal satisfaction. Also explored are the implications of the experiment for the educational programs of congregations. The greater interest in education by the new generation of elderly presents new opportunities to the churches.     

The psychosocial impact of multiple sclerosis: exploring the patient's perspective.

This study examined subjective patient experiences of the psychosocial consequences of multiple sclerosis (MS). Fifty patients were interviewed regarding the effects MS had on their lives and interpersonal relationships. These statements were collated and administered with a 5-point Likert scale to 94 MS patients. The responses were subjected to factor analysis. Three areas of subjective patient experience of the psychosocial consequences of MS emerged: demoralization, benefit-finding, and deteriorated relationships. Of particular interest was benefit-finding, which included a deepening of relationships, enhanced appreciation of life, and an increase in spiritual interests. Although benefit-finding was related to adaptive coping strategies such as positive reappraisal and seeking social support, it was unrelated to depression and was related to higher levels of anxiety and anger. These findings indicate that benefit-finding is a substantial and poorly understood part of the illness experience for MS patients.     

Relations Between Coping and Positive and Negative Outcomes in Carers of Persons with Multiple Sclerosis (MS)

This study examined relations between stress and coping predictors and negative and positive outcomes in MS caregiving. A total of 222 carers and their care-recipients completed questionnaires at Time 1 and three months later, Time 2 (n = 155). Predictors included care-recipient characteristics (age, time since diagnosis, course and life satisfaction), and Times 1 and 2 carer problems, stress appraisal and coping. Dependent variables were Time 2 negative (anxiety, depression) and positive outcomes (life satisfaction, positive affect, benefits). Regressions indicated that, overall, the hypothesised direct effects of stress appraisal and coping strategies on positive and negative outcomes were supported. The hypothesised stress-buffering effects of positive reframing coping were also supported. All but one of the coping strategies were related to both positive and negative outcomes; specifically, practical assistance coping emerged as a unique predictor of distress. Of the model predictors, care-recipient life satisfaction emerged as the strongest and most consistent predictor of both positive and negative outcomes except benefit finding. Findings support the role of care-recipient characteristics and the carers appraisal and coping processes in shaping both positive and negative outcomes. The guiding framework and findings have the potential to inform interventions designed to promote well-being in carers.     

The ‘Connection’ Health Care Providers Make with Dying Patients

SUMMARY

The literature confirms illness and hospitalisation can become spiritual encounters for patients and their families. Further, it has been established that both patients and their families are better equipped to deal with loss and change if they have a healthily developed spiritual sense of self. The aim of the study sought to determine the benefit or otherwise of a previous model of spiritual care. It asked ‘from the perspective of the nurse and other health care providers, what constitutes spiritual care giving?’ An ethnography was undertaken where data consisted of field notes, interviews, records, and diary entries. This paper reports on interview data, from which themes were derived. The major theme titled their space is expressed via a new model of spiritual care. It was shown that when caring for patients and their relatives, nurses and other health care professionals enter the world of the other to determine the other's needs. In so doing they typify agapé (altruistic love), where the individual cares for a complete stranger as if that stranger were family. This connection with the patient and their family is the foundation for spiritual care.