Positive and negative life changes experienced by survivors, of non-Hodgkin's Lymphoma

Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892, USA.
Annals of Behavioral Medicine (Impact Factor: 4.2). 11/2007; 34(2):188-99. DOI: 10.1080/08836610701566936
Source: PubMed


The impact of cancer on adult survivors of aggressive non-Hodgkin's Lymphoma (NHL) is understudied.
We examined positive and negative life changes (health behaviors, relationships, financial situation) experienced by survivors of NHL and their association with physical and mental function.
Using the Los Angeles County Cancer Surveillance Program, 744 questionnaires were mailed to adult survivors of NHL: 308 provided complete data for analyses (M age=59.8, SD=14.9).
Perceptions of positive and negative life changes were common in our sample, with 77.9% of NHL survivors reporting at least one positive change and 78.6% reporting at least one negative change. Cancer had the greatest positive change on relationships and the most negative change on survivors' financial situation. There was an equal distribution of survivors classified as having experienced positive change and negative change on health behaviors. Regardless of whether positive and negative life change were entered into separate regression models or the same model, an increase in negative life change in each of the domains was significantly associated with a decrease in physical and mental functioning. Positive change was significantly associated only with physical functioning when examining overall change (p=.018) and health behaviors (p=.013), and the inclusion of negative change attenuated these associations.
In designing interventions to improve the mental and physical function of NHL survivors, the greatest benefit may likely be achieved by reducing the negative effects of cancer. Perhaps positive life changes are related in more specific ways to other indexes of adjustment, but our findings failed to show a positive relationship with mental and physical function.

Download full-text


Available from: Keith M Bellizzi, Feb 16, 2015
    • "The diagnosis and treatment of cancer includes potentially psychologically traumatic experiences for patients. Individuals have to adapt to symptoms and side effects, which may cause meaningful disruptions across several life domains (Bellizzi et al. 2007; Mols et al. 2009). However, a growing body of recent literature has reported that a significant percentage of cancer patients (approximately 70-90 %) also experience positive life changes, namely posttraumatic growth (PTG) (Cordova et al. 2007; Lelorain et al. 2010; Schroevers and Teo 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer can be a life-threatening illness; however, it can also be a source of positive life changes, the posttraumatic growth (PTG) that comes from struggling with this serious illness. This cross-sectional study examines the sociodemographic and cancer-related predictors of PTG following a diagnosis of cancer. In addition, the relationships among adult attachment, health-related quality of life, and PTG are investigated. Measuring adult attachment is important because it can greatly influence the response to a highly distressing event, like facing cancer. Immediately before undergoing radiotherapy, 152 patients with breast or prostate cancer (mean = 59.1 years old, SD = 10.7) who had received a positive diagnosis within an average of 3.5 months prior to treatment were tested for measures of PTG, adult attachment, and health-related quality of life. Patients also completed a questionnaire regarding medical and sociodemographic characteristics. Hierarchical multiple regression analyses were conducted to reveal the significant predictors of PTG total score and PTG subscale scores. Younger age was a significant predictor of the PTG total score and New Possibilities subscale score. Subjective severity of cancer was positively associated with the PTG total score and scores on the Appreciation of Life and New Possibilities subscales. Regarding health-related quality of life, analyses indicated that greater social/family well-being significantly predicted greater PTG total score and higher scores on the New Possibilities, Spiritual Change, Appreciation of Life, and Relating to Others subscales. Finally, dismissive attachment style predicted fewer scores on the Personal Strength and Relating to Others subscales. These findings suggest that in addition to quality of life and adult attachment, sociodemographic and cancer-related variables may significantly contribute to positive growth.
    No preview · Article · Feb 2015 · Tumori
  • Source
    • "While the occurrence of benefit-finding in both cancer survivors (e.g., Antoni et al., 2001; Bellizi, Miller, Arora, & Rowland, 2007; Burris & Andrykowski, in press) and caregivers (Kim, Schulz, & Carver, 2007) is well-documented, our study adds to the small literature suggesting benefit-finding might also occur after receipt of test results that suggest only the possibility of increased risk for a future cancer diagnosis (Low et al., 2008). However, the " threat " and consequent benefit finding evident in the context of cancer screening settings might be less than that characteristic of the cancer survivor setting. "
    [Show abstract] [Hide abstract]
    ABSTRACT: All cancer screening tests produce a proportion of abnormal results requiring follow up. Consequently, the cancer-screening setting is a natural laboratory for examining psychological and behavioural response to a threatening health-related event. This study tested hypotheses derived from the social cognitive processing and cognitive-social health information processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n = 278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), social environment (social support and constraint), emotional processing, distress, and benefit finding were obtained. Regression analyses indicated greater distress was associated with greater social constraint and emotional processing and a monitoring coping style in women with a family history of OC. Distress was unrelated to social support. Greater benefit finding was associated with both greater social constraint and support and greater distress. The primacy of social constraint in accounting for both benefit finding and distress was noteworthy and warrants further research on the role of social constraint in adaptation to stressful events.
    Full-text · Article · Apr 2010 · Psychology & Health
  • Source
    • "For example, many survivors experience health and body image concerns that are specifically cancer-related [8–10]. In addition, research with cancer patients has increasingly recognized that a large proportion report positive life changes or personal growth as a result of their illness, a construct referred to as benefit finding [11–16]. Generic HRQOL measures are generally not designed to capture these domains. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Self-report instruments such as the Impact of Cancer (IOC) are designed to measure quality of life (QOL) impacts that cancer survivors attribute to their cancer experience. Generalizability of QOL findings across distinct diagnostic categories of survivors is untested. We compare measurement of the impact of cancer using the IOC instrument in breast cancer (BC) survivors (n = 1,188) and non-Hodgkin lymphoma (NHL) survivors (n = 652). A registry-based sample of NHL survivors completed the IOC questionnaire and the FACT-G, FACT-LYM, Medical Outcomes Study (MOS) SF-36, Post-Traumatic Stress Disorder Checklist-Civilian Version, Post-Traumatic Growth Inventory and MOS Social Support scales. IOC responses of the NHL survivors were subjected to de novo scaling to identify impact domains for comparison to IOC version 2 (IOCv2) domains, which were previously developed based on BC survivor responses. Concurrent validity was assessed by correlating the IOCv2 scales with the other measures. IOCv2 scores were compared between the BC and NHL survivor samples. The BC and NHL survivors exhibited similar impact domains and had factor structures that were largely congruent. The concurrent validity analysis revealed patterns of association that supported the interpretation and validity of the IOCv2 scales. Differences in IOCv2 scores between the BC and NHL groups suggested differential impacts in distinct survivor groups that could be detected using the IOCv2. The results suggest that the IOCv2 measures common and important survivor concerns and support its generalizability to the broader long-term cancer survivor population. Instruments such as the IOCv2 can provide valid assessment of QOL impacts in long-term cancer survivors, facilitating the characterization of these impacts and development of appropriate interventions.
    Full-text · Article · Dec 2009 · Journal of Cancer Survivorship
Show more