The Roles of Support Seeking and Race/Ethnicity in Posttraumatic Growth Among Breast Cancer Survivors.
ABSTRACT Posttraumatic growth (PTG) after cancer can minimize the emotional impact of disease and treatment; however, the facilitators of PTG, including support seeking, are unclear. The authors examined the role of support seeking on PTG among 604 breast cancer survivors ages 40 to 64 from the Health Eating, Activity, and Lifestyle (HEAL) Study. Multivariable linear regression was used to examine predictors of support seeking (participation in support groups and confiding in health care providers) as well as the relationship between support seeking and PTG. Support program participation was moderate (61.1%) compared to the high rates of confiding in health professionals (88.6%), and African Americans were less likely to report participating than non-Hispanic Whites (odds ratio = .14, confidence intervals [0.08, 0.23]). The mean (SD) PTG score was 48.8 (27.4) (range 0-105). Support program participation (β = 10.4) and confiding in health care providers (β = 12.9) were associated (p < .001) with higher PTG. In analyses stratified by race/ethnicity, PTG was significantly higher in non-Hispanic Whites and African American support program participants (p < .01), but not significantly higher in Hispanics/Latinas. Confiding in a health care provider was only associated with PTG for non-Hispanic Whites (p = .02). Support program experiences and patient-provider encounters should be examined to determine which attributes facilitate PTG in diverse populations.
SourceAvailable from: Maria Elena Magrin[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study is to investigate the role of social support and coping strategies in enhancing post-traumatic growth (PTG) in cancer patients. The study focused on both avoidance and approaching coping and on four distinct types of social support: (a) perceived availability, (b) actual received, (c) satisfaction with received support, and (d) the competence of caregiver to satisfy the patient's basic psychological needs of autonomy, competence, and relatedness. A longitudinal study was conducted with a group of 41 cancer patients currently in the treatment and management phase of their illness. Data were collected by means of a written questionnaire, at two time points (T1 and T2) that were 6 months apart. Social support was assessed using the Interpersonal Support Evaluation List and the Need Satisfaction in Relationship Scale. Coping strategies were assessed using the Brief COPE questionnaire. Social support and coping strategies were assessed only at T1. PTG was assessed using the Post-Traumatic Growth Inventory at T1 and T2. Correlation and regression analyses were used to examine the association between social support and coping strategies with short-term reports of post-traumatic growth. Regression analyses showed that autonomy-supportive caregivers and a problem-focused strategy of coping significantly predicted greater PTG at T2. This study contributes to a deeper understanding of the type of social support that may specifically aid cancer patients in experiencing PTG. Furthermore, findings confirm the important role of problem-focused coping strategies in growing psychologically.Psycho-Oncology 08/2011; 20(8):823-31. DOI:10.1002/pon.1782 · 4.04 Impact Factor
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ABSTRACT: Evidence has been inconsistent regarding the impact of social networks on survival after breast cancer diagnosis. We prospectively examined the relation between components of social integration and survival in a large cohort of breast cancer survivors. Women (N=4,589) diagnosed with invasive breast cancer were recruited from a population-based, multi-center, case-control study. A median of 5.6 years (Interquartile Range 2.7-8.7) after breast cancer diagnosis, women completed a questionnaire on recent post-diagnosis social networks and other lifestyle factors. Social networks were measured using components of the Berkman-Syme Social Networks Index to create a measure of social connectedness. Based on a search of the National Death Index, 552 deaths (146 related to breast cancer) were identified. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Higher scores on a composite measure of social connectedness as determined by the frequency of contacts with family and friends, attendance of religious services, and participation in community activities was associated with a 15-28% reduced risk of death from any cause (p-trend=0.02). Inverse trends were observed between all-cause mortality and frequency of attendance at religious services (p-trend=0.0001) and hours per week engaged in community activities (p-trend=0.0005). No material associations were identified between social networks and breast cancer-specific mortality. Engagement in activities outside the home was associated with lower overall mortality after breast cancer diagnosis.Journal of Cancer Survivorship 12/2010; 4(4):372-80. DOI:10.1007/s11764-010-0139-5 · 3.57 Impact Factor
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ABSTRACT: Finding positive changes in the aftermath of breast cancer (BC) may protect women against impaired adjustment. This study examines posttraumatic growth (PTG) in a sample of women receiving treatment for BC and explores the buffering role of PTG on the links between perceived impact of BC and emotional distress and quality of life (QoL). Seventy-eight women receiving chemotherapy (n = 57) or radiotherapy (n = 21) completed the Portuguese versions of the Posttraumatic Growth Inventory, the Hospital Anxiety and Depression Scale, the World Health Organization for QoL-Bref and Consequences sub-scale of the Brief Illness Perception Questionnaire (assessing perceived impact of BC). PTG was frequently reported and co-existed with distress and dysfunction. A more negative perception of the impact of BC was significantly associated with higher emotional distress and impaired Physical and Psychological QoL, but was unrelated to PTG. Hierarchical regression analyses showed that PTG moderated these relationships, acting as a stress-buffering mechanism. Among women who perceived BC as having a more negative impact on their lives, higher levels of PTG buffered this negative perceived impact on Psychological and Social QoL (p<0.01) and also on Depression (p<0.06). This effect was not found for Physical QoL and Anxiety. Results provide support for the stress-buffering role of PTG. Finding positive changes in cancer experience seems to protect women from the effects of a negative perception of the impact of BC on adjustment. Psychosocial intervention programs should facilitate PTG in order to promote women's adjustment.Psycho-Oncology 02/2011; 21(4):409-18. DOI:10.1002/pon.1913 · 4.04 Impact Factor