Posttraumatic Growth in Breast Cancer Survivors

描述(申请人提供)：这项申请建议进行二次数据分析，以利用一个独特的机会，扩大现有的关于积极心理适应的知识，特别是女性乳腺癌幸存者的创伤后成长(PTG)。我们建议使用现有的女性乳腺癌幸存者(N=653)的大型纵向数据集，在18个月(诊断后最多24个月)的5个时间点进行跟踪。PTG是一个多维结构，定义为一个人在与具有高度挑战性的生活环境作斗争后所经历的积极心理变化的感知。1、2自1996年推出创伤后成长问卷(PTGI)以来，它已被广泛用于研究PTG，是癌症患者积极心理变化最常用的测量工具。拟议的分析将使我们能够审查关于PTG和PTGI的一些重要的、悬而未决的问题。先前关于PTG的研究表明，癌症幸存者通常在确诊后报告一定程度的PTG。关于PTG的研究也指出了与长期心理和身体健康的潜在关系，但主要是横向的，还没有充分探索与PTG相关的潜在后果。最初研究的主要目的是检验可能解释首次诊断为乳腺癌的女性在与健康相关的生活质量(特别强调心理发病率)方面的年龄差异的机制。两个地点的新诊断癌症幸存者在基线、诊断后3、6、12和18个月完成了PTG、癌症特异性和一般生活质量(QOL)、抑郁、灵性、应对、疾病侵入性、乐观和积极和消极社会支持的测量。还收集了社会人口学变量和广泛的医疗/治疗变量。初步结果表明，这个数据集中的女性经历了PTG，并且随着时间的推移，它会增加。本研究的目的是：(1)增加对特定PTGI评分与身心健康的意义和意义的理解；(2)确定PTG随时间的变化的预测因素；(3)识别和检查共同的PTG轨迹及其预测因素，以及共同轨迹与心理和身体健康结果之间的关系。以前没有研究检查过癌症幸存者样本中常见的PTG轨迹。拟议的分析将使我们能够更好地了解乳腺癌幸存者PTG的时机、模式和临床意义。 公共卫生相关性：这项研究的目标是使用现有的纵向数据集(N=653)来检查乳腺癌幸存者的创伤后生长(PTG)。PTG是一种多维结构，被定义为“在与具有高度挑战性的生活环境作斗争时所经历的积极心理变化”，癌症幸存者通常报告，即使在重大的身体和情感压力中也是如此。鉴于乳腺癌幸存者的数量不断增加，以及需要更好地了解他们的需求，我们将研究PTG的轨迹及其预测因素，以及PTG自我报告是否与更好的心理和身体健康有关。

DESCRIPTION (provided by applicant): This application proposes to conduct secondary data analyses to capitalize on a unique opportunity to expand existing knowledge of positive psychological adaptation, specifically posttraumatic growth (PTG), in female breast cancer survivors. We propose to use of a large, existing, longitudinal dataset of female breast cancer survivors (N=653) followed at up to five time points over 18 months (up to 24 months post-diagnosis). PTG is a multidimensional construct defined as one's perception of "positive psychological change experienced as a result of the struggle with highly challenging life circumstances."1,2 Since the Posttraumatic Growth Inventory (PTGI) was introduced in 1996, it has been widely used to study PTG and is the most frequently used measure of positive psychological change in cancer patients. The proposed analyses will allow us to examine some important, unanswered questions about PTG and the PTGI. Previous research on PTG indicates that cancer survivors often report some level of PTG following diagnosis. The research on PTG also points to the potential relationships with long-term psychological and physical health, but has been predominantly cross-sectional in nature and has not sufficiently explored potential outcomes associated with PTG. The primary purpose of the original study was to examine mechanisms that may explain age differences in the health-related quality of life (with a particular emphasis on psychological morbidity) of women who have been diagnosed with a first-time breast cancer. Newly diagnosed cancer survivors across two sites completed measures of PTG, cancer- specific and general quality of life (QOL), depression, spirituality, coping, illness intrusiveness, optimism, and positive and negative social support at baseline, 3, 6, 12, and 18 months post diagnosis. Sociodemographic variables and extensive medical/treatment variables were collected as well. Preliminary results suggest that the women in this dataset experienced PTG and it increased over time. Aims of this study are: (1) to increase understanding of the meaning and significance of specific PTGI scores in relation to mental and physical health; (2) to identify predictors of PTG over time; and (3) to identify and examine common PTG trajectories and their predictors as well as relationships between common trajectories and mental and physical health outcomes. No prior study has examined common PTG trajectories in a cancer survivor sample. The proposed analyses will allow us to better understand the timing, patterns, and clinical significance of PTG in breast cancer survivors. PUBLIC HEALTH RELEVANCE: The goal of this study is to examine osttraumatic growth (PTG) in breast cancer survivors using an existing longitudinal dataset (N=653). PTG is a multidimensional construct defined as "positive psychological change experienced as a result of the struggle with highly challenging life circumstances" and is commonly reported by cancer survivors, even in the midst of significant physical and emotional stressors. Given the increasing number of breast cancer survivors and the need to better understand their needs, we will examine trajectories of PTG and their predictors and whether PTG self-reported is associated with better mental and physical health.