Rumination, post-traumatic growth, and distress: structural equation modelling with cancer survivors
Rumination, post-traumatic growth, and distress: structural equation modelling with cancer survivors
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DOI：
10.1002/pon.1827
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发表时间：
2011-11-01
期刊：
影响因子：
3.6
通讯作者：
Shakespeare-Finch, Jane
中科院分区：
文献类型：
--
作者：
Morris, Bronwyn A.;Shakespeare-Finch, Jane
目的：创伤后成长(PTG)的理论模型已经在一般创伤文献中被派生出来，以描述创伤后的经历，促进人们对积极生活变化的感知。为了建立一个统计模型来确定与PTG相关的因素，本研究使用结构方程模型(SEM)来评估诊断严重性知觉、沉思、社会支持、苦恼和PTG之间的关系。方法：对被诊断为多种癌症的受试者(N=313)进行了PTG的统计模型检验。结果：用于评估沉思的测量的初始主成分分析揭示了三个成分：侵入性沉思、对利益的刻意深思和对生活目的的深思。扫描电子显微镜结果表明，模型能很好地拟合数据，PTG的30%的方差可以用变量来解释。创伤严重程度与痛苦程度直接相关，但与创伤后应激障碍无关。刻意反思福利和社会支持与创伤后应激障碍直接相关。结论：该模型显示苦恼除了具有独特的相关因素外，苦恼与PTG无关，从而支持了这两个概念在诊断后经验中是离散的概念。统计模型支持诊断后的体验同时受到积极和消极生活变化的影响，其中一种结果可能普遍存在，也可能同时发生。因此，实践的一个含义是需要从本质上说是全面的支持性护理。版权所有(C)2010 John Wiley&Sons，Ltd.
Objective: Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG.Method: A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N = 313).Results: An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress.Conclusions: The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature. Copyright (C) 2010 John Wiley & Sons, Ltd.