A Pilot Study Of Intervention To Enhance Posttraumatic Growth For Breast Cancer Based On Exploring The Related Factors

Objective:The objective of this study is to understand the level of posttraumatic growth in patients with breast cancer and to identify factors that influence the PTG of the survivors. Based on these factors, a pilot study of intervention to enhance posttraumatic growth for patients with breast cancer follow on. Exploring the relationships between resilience, perceived social support, self[efficacy and posttraumatic growth. The aim of this study is to lead the patients with breast cancer to cope trauma with positive experience that should be paied attention to, to assist clinical nurse to help patients reach better state of body and mind, so as to promote the promote the process of rehabilitation of breast cancer survivors and to improve their quality of life.Methods:There were two stages in this study. The first stage was a face to face questionnaire survey conducted in170patients being hospitalized in department of Breast Surgery of the First Affiliated Hospital of Dalian Medical University with159valid questionnaires. The questionnaire of Posttraumatic Growth Inventory, Connor-Davidson resilience scale, Perceived Social Support Scale, General Self-Efficacy Scale and the general questionnaire were used to measure breast cancer survivors’ growing social support, resilience, and self-efficacy. There was a randomized controlled trail in the second stage. Exclude the patients who received following therapy just like chemotherapy and radiotherapy in other hospital. Then they were divided into experimental group and control group by the table of random numbers. The control group was treated by the normal nursing. The experimental group was treated with the intervention by the researcher. Posttraumatic Growth Inventory and Connor-Davidson resilience scale were used to survey the two groups after one month. These were used to discuss and evaluate the effect of the intervention.Date was arranged and analyzed with SPSS17.0. Statistical methods included descriptive statistics, one way ANOVA, bivariate, multiple linear regression and t test.Results:1. Totally170patients meeting the inclusion criteria were investigated, only159questionnaires were retracted, so the effective collect rate was92.35%.2. The average score of posttraumatic growth of patients with breast cancer was(56.41±17.19).59.7%patients reported positive PTG. The dimension score from high to low order are the relationships with others (3.29±0.99), personal strength (3.19±1.00), appreciation of life (2.94±1.15)、new possibilities (2.36±1.15)。3. The score range of resilience was17-92and the average score of it was(63.36±14.43). The score range of social support was45-84and the average score of it was(69.28±8.59). The score range of self-efficacy was1.4-4.0and the average score of it was(2.78±0.65).4. Used the posttraumatic growth score as dependent variable, and age, degree of education, profession, resilience, social support, self-efficacy as independent variables for multiple liner regressions. Multivariate linear regression analysis revealed that five major influencing factors for breast cancer survivors. The regression model included5predictor variables accounting for28.7%of the variance in the total posttraumatic growth.5. Comparative result of posttraumatic growth and resilience of two groups(1) After the second course of chemotherapy,32patients of experimental group and31patients of control group were selected for statistical data according to inclusion and exclusion criteria.(2) The t-test was used to compare the score of PTGI before and after the intervention. Difference of the posttraumatic growth between two groups before the intervention had no statistical significance (P>0.05). Difference of the posttraumatic growth between two groups after the intervention had statistical significance (P<0.05), and the comparison of each group before and after the intervention had statistical difference (P<0.05).(3) The t-test was used to compare the resilience before and after the intervention. Difference of the resilience between two groups before the intervention had no statistical significance (P>0.05). Difference of the resilience between two groups after the intervention had statistical significance (P<0.05), and the comparison of each group before and after the intervention had statistical difference (P<0.05).Conclusion:1. The phenomenon of posttraumatic growth for patients with breast cancer exists, but have differences compared with other research in our country.2. The resilience, social support, self-efficacy have the positive relationship with posttraumatic growth.3. According to the results of multiple linear regression, the posttraumatic growth level for breast cancer patients is affected by resilience, average monthly income of each family member and the level of social support.4. The posttraumatic growth and resilience of experimental group is superior than control group after the intervention. So the intervention which we used in this study is effective.