A longitudinal investigation of posttraumatic growth and its associated factors among head and neck cancer survivors.

OBJECTIVES: Posttraumatic growth (PTG) may improve well-being among cancer survivors, but a longitudinal study addressing head and neck cancer (HNC) is lacking. This longitudinal study examined PTG trends and determined the associations of physical symptoms and complications, as well as sociodemographic and tumor characteristics on PTG over time among HNC survivors. METHODS: Participants completed the European Organization of Research and Treatment of Cancer's "Quality of Life Questionnaire-Head and Neck 35" module (EORTC-QLQ-H&N-35) and "Posttraumatic Growth Inventory-Short Form" (PTGI-SF) during baseline (T1 ) and follow-up (T2 ; 5-7 months post-baseline) assessments. RESULTS: In total, 200 HNC participants completed the study and 67.5% of them reported increasing PTG. Physical symptoms and complications that were significantly associated with lower PTG included problems with social contact and the senses. Meanwhile, sociodemographic variables that were significantly associated with PTG were gender (males had lower PTG than females) and religion (Muslims and Buddhists had higher PTG than participants of other religious faith). CONCLUSION: Our findings revealed the need to focus on the impact of sensory issues and reduced social contact following HNC on PTG which may be addressed by various restorative and supportive rehabilitation therapy.

Posttraumatic growth and its association with unmet supportive care needs and fear of cancer progression among head and neck cancer patients.

BACKGROUND AND AIMS: The assessment of supportive care needs and fear of cancer progression are important variables to be considered when evaluating the psychological aspects of cancer patients. However, data on how these variables affect posttraumatic growth (PTG) are lacking. This study aimed to investigate the level of PTG among head and neck cancer (HNC) patients within the first year of cancer diagnosis and to determine the association between unmet supportive care needs, fear of cancer progression, and the level of PTG. METHODS: Participants were administered socio-demographic and clinical characteristics questionnaire; the 34-item Supportive Care Needs Survey (SCNS-34) to measure the unmet needs; 12-item Fear of Progression Questionnaire-Short Form (FoP-Q-SF) to measure the fear of progression of cancer; and the Posttraumatic Growth Inventory-Short Form (PTGI-SF) to measure the degree of PTG. RESULTS: A total of 190 HNC participants reported a mean total PTGI-SF score of 39.3 (standard deviation = 9.5). General linear model revealed that higher degree of patients' physical and daily living unmet needs and fear of cancer progression significantly predicted lower PTG, after controlling for sociodemographic and clinical factors. CONCLUSION: HNC patients within the first year of cancer diagnosis reported a high level of PTG. Despite that, psychosocial intervention for HNC patients should emphasize on counteracting patients' physical and daily living unmet needs and fear of cancer progression to improve the psychological well-being of patients.

Posttraumatic Growth, Positive Psychology, Perceived Spousal Support, and Psychological Complications in Head and Neck Cancer: Evaluating Their Association in a Longitudinal Study.

Despite head and neck cancer (HNC) association with various negative impacts, collective evidence is accumulating regarding the positive impacts of positive psychology on cancer survivors. However, data on how positive psychology is related to the psychological complications of HNC across time are lacking. This longitudinal study examined the trends of positive psychology (e.g., posttraumatic growth [PTG], hope, and optimism), perceived spousal support, and psychological complications (e.g., depression, anxiety, and posttraumatic stress symptoms) and determined the association between them, psychological complications, and PTG across two timelines among a cohort of HNC patients. A total of 175 HNC respondents exhibited an increasing trend of positive psychology and perceived spousal support while reporting a decreasing trend of psychological complications between baseline and follow-up assessments. A greater degree of hope and perceived spousal support contributed to a higher degree of PTG across time. Conversely, a higher severity of anxiety symptoms was associated with a lower degree of PTG over time. Female gender had a moderating effect on the association between severity of anxiety symptoms and PTG, but did not moderate the association between hope, perceived spousal support and PTG. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support and reduce the severity of anxiety symptoms, which, in turn, will facilitate the development of PTG in HNC patients.

Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time?

Despite an enormous number of studies addressing the importance of posttraumatic growth (PTG) among cancer patients, the literature lacks data regarding how different coping strategies affect PTG among head and neck cancer (HNC) patients over time. This longitudinal study investigated the PTG trend and coping over 5-7months among a cohort of HNC patients within the first year after their diagnosis. It determined an association between coping strategies and PTG over time. The study's HNC respondents were administered a socio-demographic and clinical characteristics questionnaire during their baseline assessments. Additionally, the Malay versions of the "PTG Inventory-Short Form" (PTGI-SF) and the "Brief Coping Orientation to Problems Experienced Inventory" (Brief COPE) were administered during respondents' baseline assessments and follow-up assessments (5-7months after the baseline assessments). In total, 200 respondents reported an increasing PTG trend and approach coping (active coping, planning, positive reframing, acceptance, emotional support, and instrumental support) and a decreasing trend of avoidant coping (self-distraction and denial) over time. Two approach coping strategies (acceptance and planning) significantly increased PTG while denial was the only avoidant coping strategy that significantly lowered PTG, after controlling for socio-demographic and clinical characteristics, over time. Our study's findings identified the need to incorporate psychosocial interventions that enhance approach coping and reduce avoidant coping into HNC patients' treatment regimes.