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Abstract

This thesis comprises a comprehensive program of quantitative and qualitative studies investigating posttraumatic growth (PTG) that may be perceived after struggling with the challenges associated with a diagnosis of cancer and treatment. Study 1 examined participants diagnosed with a variety of cancers (N = 335). In addition to completing questionnaires, 62% of participants also provided a written narrative of their cancer experience. Structural equation modelling of quantitative measures indicated rumination to be an important variable associated with post-diagnosis outcomes, and that PTG had distinct predictors from distress. Social support and deliberately ruminating on benefits predicted PTG, while trauma severity, intrusive rumination and life purpose rumination predicted distress.
Analyses also revealed differences in levels of PTG associated with type of cancer diagnosis. Breast cancer survivors (M = 64.4 7, SD = 22.19) reported higher PTG than haematological (M = 52.22, SD = 24.45) and colorectal (M = 51.44, SD = 22.45) cancer survivors. Prostate cancer survivors (M= 58.86, SD = 20.14) were not significantly different from other groups. Breast cancer survivors also had higher levels of coping effort, cognitive processing regarding benefits, intrusive and life purpose rumination, current distress, and lower helplessness than other cancer diagnosis groups. These differences in PTG across diagnoses remained after controlling for age and gender.
Study 2 collected data three times over 12 months from participants newly diagnosed with a haematological malignancy and their spouses (N = 11). Qualitative results supported the model of themes proposed in Study 1, showing that participants displaying resilient characteristics did not perceive PTG to the same extent as participants who perceived their cancer to be of such magnitude that it changed their life. Resilient participants felt psychologically prepared as a result of prior adversities. Perhaps these past challenges had helped them to develop or strengthen their coping skills, and hence helped them to manage the challenges posed by their cancer experience. In both studies, participants strongly endorsed additional qualitative domains of PTG (e.g., health-related benefits and compassion). These findings suggesting that studies utilising traditional measures of PTG may overlook important features of positive life change in people coping with illnesses such as cancer.
In summary, the results from these studies indicate i) the importance in considering rumination in terms of both growth and distress, ii) the potential differences in adjustment and PTG between cancer diagnoses, and iii) utilising measures that capture the full extent of PTG in an illness-related context. This thesis discusses the implications of these findings and suggests avenues for further research to inform public health policy and service provision in relation to holistic psychosocial adjustment to a diagnosis of cancer.

Item Type:	Thesis - PhD
Authors/Creators:	Morris, BA
Copyright Information:	Copyright 2009 the author
Additional Information:	Thesis (PhD)--University of Tasmania, 2009. Includes bibliographical references
Related URLs:	Published article from appendix H
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