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      Posttraumatic growth and death anxiety in caregivers of cancer patients: PHOENIX study

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          Abstract

          Background/aim

          Posttraumatic growth (PTG) is defined as positive psychological changes following a challenging or traumatic life event. The purpose of this study is to define the predictors of PTG and death anxiety (DAN) in caregivers of cancer patients and evaluate the impact of DAN on PTG.

          Materials and methods

          The caregivers of cancer patients were evaluated using structured questionnaires, including a validated PTG scale and Templer death anxiety scale.

          Results

          In 3 different cancer centers, 426 participants were evaluated. In multivariate analysis of factors associated with PTG, a high DAN score was the only parameter associated with high PTG scores [OR: 1.6, CI (95%) 1.02–2.5, P = 0.03]. In multivariate analysis of factors associated with DAN, female sex was the only risk factor for high DAN scores [OR: 1.6, CI (95%) 1.1–2.8, P = 0.049]. There was a positive correlation between PTG and DAN scores (r = 0.15, P = 0.001). Higher DAN scores were associated with positive impacts on self-perception (37.0 versus 35.0, P = 0.02), philosophy of life (16.0 versus 13.0, P = 0.035), and changes in relationship (16.0 versus 14.0, P = 0.01)

          Conclusions

          This is the first report regarding the association between DAN and PTG. We found a positive impact of death anxiety on psychological changes in caregivers of cancer patients.

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          Most cited references25

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          Posttraumatic growth in Chinese cancer survivors.

          To investigate the dimensions and determinants of posttraumatic growth among Chinese cancer survivors, 188 participants were asked to complete a Chinese posttraumatic growth inventory, translated from the Posttraumatic Growth Inventory (PTGI; J Trauma Stress 1996; 9: 455-471), together with the Chinese versions of the Hospital Anxiety and Depression scale, the Mini-Mental Adjustment to Cancer scale, and the General Health Questionnaire. Confirmatory factor analysis showed a different factor structure than the original English-language version of the PTGI. The dimensions of growth could also be broadly dichotomized into an Interpersonal and an Intrapersonal dimension in our Chinese sample. Multiple regression analysis showed that positive coping was the most important determinant of posttraumatic growth when compared with negative coping and psychological symptoms. A Chinese Posttraumatic Growth Inventory was developed to facilitate future research. Copyright 2003 John Wiley & Sons, Ltd.
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            Fear of recurrence and psychological distress in head and neck cancer patients and their carers.

            Fear of recurrence (FOR) has been increasingly recognised as an issue of significant burden for most cancer patients, and has been associated with psychological morbidity and reduced quality of life. More recently, the impact of recurrence fears has been indicated in the families of cancer patients. However, there has been a lack of prospective research. To systematically examine distress and illness concerns among patient-carer dyads. A multi-centre prospective study of head and neck cancer patients and their carers (patients, n=101; carers, n=101), surveyed at two time-points following diagnosis. Carers recorded higher recurrence concerns on average than the patient group (p<0.001). A predictive path model of patient and carer self-reports of distress and FORs was explored, with an excellent overall fit of the final model (chi(2)=15.4, df=12, p=0.22, Comparative Fit Index (CFI)=0.994, Root Mean Square Estimate of Approximation (RMSEA)=0.053). The preliminary results establish that early fears and distress within individuals govern later reports on these same attributes, but that there is some weak evidence of influence from one attribute to another within and across individuals in the dyad. Future prospective dyadic research is warranted to ascertain the level of these fears over an extended time and their relationship to patient and carer adaptation. Intervention may be needed to reduce this disease concern to a manageable level at an early stage of the illness trajectory.
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              Posttraumatic growth after breast cancer: patient, partner, and couple perspectives.

              The purpose of this study was to evaluate posttraumatic growth among breast cancer patients and their significant others over a 1(1/2)-year time span after diagnosis and to examine cognitive and emotional processes in posttraumatic growth. One hundred sixty-two women with breast cancer and their partners completed surveys assessing posttraumatic growth, cognitive and emotional processing, and marital satisfaction at 3 time points spaced 9 months apart. Posttraumatic growth increased for both partners during this period. Patient posttraumatic growth was predicted by younger age, contemplating reasons for cancer, and more emotional expression at time 1. Partner posttraumatic growth was predicted by younger age, more intrusive thoughts, and greater use of positive reappraisal and emotional processing at time 1. Posttraumatic growth is reported by patients and by significant others. Cognitive and emotional processes predict growth. Patient growth is associated with the significant other's cognitive and emotional processing of breast cancer.
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                Author and article information

                Journal
                Turk J Med Sci
                Turk J Med Sci
                Turkish Journal of Medical Sciences
                The Scientific and Technological Research Council of Turkey
                1300-0144
                1303-6165
                2020
                26 August 2020
                : 50
                : 5
                : 1364-1370
                Affiliations
                [1 ] Department of Medical Oncology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla Turkey
                [2 ] Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara Turkey
                [3 ] Department of Medical Oncology, Bağcılar Education and Research Hospital, İstanbul Turkey
                [4 ] Department of Anesthesiology and Reanimation, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla Turkey
                [5 ] Department of Palliative, Rehabilitation, and Integrative Medicine; the University of Texas MD Anderson Cancer Center, Houston, Texas USA
                Author notes
                * To whom correspondence should be addressed. E-mail: alkanali@ 123456yahoo.com

                CONFLICT OF INTEREST:

                There is no conflict of interest.

                Author information
                https://orcid.org/0000-0002-8253-5046
                https://orcid.org/0000-0002-6590-4444
                https://orcid.org/0000-0001-8802-6376
                https://orcid.org/0000-0003-3465-2464
                https://orcid.org/0000-0002-8745-0412
                https://orcid.org/0000-0002-7156-4650
                Article
                10.3906/sag-2001-228
                7491265
                32490635
                d4226b75-df2a-4458-bd11-f0d8fdf37430
                Copyright © 2020 The Author(s)

                This article is distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use and redistribution provided that the original author and source are credited.

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                Article

                posttraumatic growth,death anxiety,caregivers,relatives,cancer

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