Posttraumatic Growth in Breast Cancer Survivors

描述（由申请方提供）：本申请建议进行二次数据分析，以利用独特的机会扩展女性乳腺癌幸存者积极心理适应的现有知识，特别是创伤后成长（PTG）。我们建议使用一个大型的，现有的，纵向数据集的女性乳腺癌幸存者（N=653），在18个月（诊断后24个月）的5个时间点。PTG是一个多维度的结构，定义为一个人对“由于与高度挑战性的生活环境作斗争而经历的积极心理变化”的感知。自1996年创伤后成长量表（PTGI）问世以来，它已被广泛用于研究PTG，是癌症患者积极心理变化的最常用指标。拟议的分析将使我们能够检查一些重要的，未回答的问题PTG和PTGI。先前关于PTG的研究表明，癌症幸存者在诊断后经常报告一定程度的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，但在本质上主要是横截面的，并没有充分探讨与PTG相关的潜在结果。最初研究的主要目的是检查可能解释首次诊断患有乳腺癌的女性的健康相关生活质量（特别强调心理发病率）的年龄差异的机制。在基线、诊断后3、6、12和18个月，两个研究中心新诊断的癌症幸存者完成了PTG、癌症特异性和一般生活质量（QOL）、抑郁、精神、应对、疾病侵入性、乐观以及积极和消极社会支持的测量。还收集了社会人口统计学变量和广泛的医疗/治疗变量。初步结果表明，该数据集中的女性经历了PTG，并且随着时间的推移而增加。本研究的目的是：（1）增加对特定PTGI评分与心理和身体健康相关的含义和意义的理解;（2）确定PTG随时间的预测因素;（3）确定和检查常见PTG轨迹及其预测因素以及常见轨迹与心理和身体健康结果之间的关系。没有先前的研究已经检查了常见的PTG轨迹在癌症幸存者样本。拟议的分析将使我们能够更好地了解乳腺癌幸存者中PTG的时机、模式和临床意义。 公共卫生相关性：本研究的目的是使用现有的纵向数据集（N=653）检查乳腺癌幸存者的创伤后生长（PTG）。PTG是一个多维度的概念，被定义为“由于与极具挑战性的生活环境的斗争而经历的积极心理变化”，并且通常由癌症幸存者报告，即使在显著的身体和情感压力中。鉴于乳腺癌幸存者的数量不断增加，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相关。

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.