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Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer
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Original Article

Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer

Korean Journal of Adult Nursing 2016;28(3):247-255.
Published online: June 30, 2016

1Pusan National University Yangsan Hospital, Yangsan

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Corresponding author: Jun, Seong Sook College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-51-510-8358, Fax: +82-51-510-8308, E-mail: jss@pusan.ac.kr
• Received: January 30, 2016   • Accepted: June 17, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to investigate the influencing factors on Posttraumatic Growth(PTG) in patients with colorectal cancer.
  • Methods
    Eighty patients who were diagnosed with colorectal cancer at least twelve months ago were recruited from the oncology outpatient clinic of university hospital in Y city. Participants completed four survey questionnaires: Korean versions of PTG Index, Korean versions of Cancer Coping Questionnaire, Multidimensional Scale of Perceived Social Support, and a Resilience Scale. The data were analyzed by ANOVA, Pearson-correlation coefficient, and multiple regression analysis.
  • Results
    The mean score of PTG in these patients was 51.16 indicating relatively high growth. Posttraumatic Growth had significant correlations with coping, social support, and resiliency. In addition to the variables of age and education that are found to be associated with the PTG, the PTG was significantly influenced by resilience, coping, and importance of religion. Forty-nine percent of the variations in the PTG were explained by these three variables.
  • Conclusion
    The identified factors influencing colorectal cancer related to PTG could be considered in developing nursing interventions to promote positive psychological changes in response to adversity which colorectal cancer survivors might experience.
Table 1.
Status of Posttraumatic Growth and related Factors in Patients with Colorectal Cancer (N=80)
Variables M±SD Range
Posttraumatic growth 51.16±14.04 0~80
 Personal strength 20.55±5.45 0~30
 Relating to others 16.09±4.72 0~25
 New possibilities 9.49±3.39 0~15
 Spiritual change 5.04±2.59 0~10
Coping 54.43±12.75 23~92
 Interpersonal 21.95±6.93 9~36
 Individual 32.48±7.81 14~56
 Positive focus 15.88±4.07 6~24
 Coping 10.30±2.95 5~20
 Planning 6.30±2.35 3~12
Social support 40.93±7.96 12~60
 Significant others 10.61±4.71 4~20
 Family 16.40±2.66 4~20
 Friends 13.91±3.46 4~20
Resilience 99.10±12.36 27~135
 Cause analytical 11.36±1.82 3~15
 Emotion control 11.12±2.08 3~15
 Urges restraint 11.35±1.82 3~15
 Gratitude 11.15±2.26 3~15
 Life satisfaction 9.98±2.37 3~15
 Optimism 11.85±1.76 3~15
 Relationship 11.56±2.41 3~15
 Communication 10.09±2.38 3~15
 Empathy 10.64±2.03 3~15
Table 2.
Difference in Posttraumatic Growth based on Sociodemographic and Disease related Characteristics (N=80)
Characteristics Categories n (%) M±SD t or F p Scheffé
Gender Male 46 (57.5) 50.5±13.65 -0.51 .611
Female 34 (42.5) 51.1±14.73
Age (year) ≤49a 19 (23.8) 58.6±10.34 4.01 .011 a>b
50~59b 18 (22.5) 43.8±15.09
60~69c 26 (32.5) 52.1±10.83
≥70d 17 (21.2) 49.2±17.17
Marital status Single 6 (7.5) 48.7±3.33 2.58 .083
Married 60 (75.0) 53.1±14.11
Separation 14 (17.5) 44.0±14.70
Number of children 0 12 (15.0) 49.0±12.12 1.64 .186
1 9 (11.2) 42.9±18.48
2 35 (43.8) 54.0±13.38
≥3 24 (30.0) 51.3±14.50
Education completed ≤Middle schoola 20 (25.0) 49.8±13.37 3.48 .036 b<c
High schoolb 38 (47.5) 48.2±13.72
≥Collegec 22 (27.5) 57.6±13.67
Job No 56 (70.0) 51.1±14.72 0.04 .967
Yes 24 (30.0) 51.3±12.64
Income No 49 (61.3) 50.4±15.01 -0.59 .560
Yes 31 (38.7) 52.3±12.32
Religion No 24 (30.0) 48.6±15.09 0.65 .629
Yes 56 (70.0) 52.3±13.57
Importance of religion Not importanta 25 (31.3) 44.4±13.85 4.70 .012 a<b
A little importantb 39 (48.8) 54.6±11.29
Very importantc 16 (20.0) 53.3±17.22
Character Extrovert 29 (36.3) 55.6±11.84 2.17 .033
Introvert 51 (63.7) 48.6±14.82
Cancer stage I 1 (1.3) 52.0 0.59 .621
II 10 (12.5) 54.9±7.77
III 44 (55.0) 49.3±14.29
IV 25 (31.2) 52.8±15.67
Therapy method Surgery 7 (8.8) 48.1±11.02 1.19 .320
Surgery+chemo 52 (65.0) 49.6±14.27
Surgery+chemo+radiation 19 (23.8) 56.2±13.92
Other 2 (2.5) 55.0±16.97
Ostomy Yes 10 (12.5) 49.2±13.39 0.01 .929
No 70 (87.5) 51.4±14.21
Table 3.
Correlational Relationships among Major Variables (N=80)
Variables PTG PTG; Personal strength PTG; Relating to others PTG; New possibilities PTG; Spiritual change
r (p) r (p) r (p) r (p) r (p)
Coping .55 (<.001) .49 (.001) .49 (<.001) .58 (<.001) .31 (.005)
Social support .34 (<.001) .36 (.001) .29 (.009) .26 (.018) .23 (.037)
Resilience .42 (<.001) .52 (<.001) .40 (<.001) .33 (.003) .05 (.653)

PTG=posttraumatic growth.

Table 4.
Factors related to Posttraumatic Growth in Patients with Colorectal Cancer (N=80)
Variable B SE β t p VIF
Resilience 0.48 0.11 .46 5.18 <.001 1.187
Coping 0.35 0.11 .34 3.82 <.001 1.224
Importance of religion (A little important) 7.20 2.72 .19 2.31 .024 1.043
Importance of religion (Very important) 4.98 3.33 .14 1.49 .139 1.398
Age -0.05 0.12 -.04 -0.36 .718 1.606
Education completed (High school) -3.25 2.95 -.12 -1.10 .274 1.707
Education completed (College and above) 0.93 3.69 .03 0.25 .801 2.138
Social support 0.01 0.17 .42 0.04 .967 1.407
Adj. R2=.48.4, F=10.270, p<.001, Durbin-Watson=2.07
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    Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer
    Korean J Adult Nurs. 2016;28(3):247-255.   Published online June 30, 2016
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    Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer
    Korean J Adult Nurs. 2016;28(3):247-255.   Published online June 30, 2016
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    Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer
    Factors Related to Posttraumatic Growth in Patients with Colorectal Cancer

    Status of Posttraumatic Growth and related Factors in Patients with Colorectal Cancer (N=80)

    Variables M±SD Range
    Posttraumatic growth 51.16±14.04 0~80
     Personal strength 20.55±5.45 0~30
     Relating to others 16.09±4.72 0~25
     New possibilities 9.49±3.39 0~15
     Spiritual change 5.04±2.59 0~10
    Coping 54.43±12.75 23~92
     Interpersonal 21.95±6.93 9~36
     Individual 32.48±7.81 14~56
     Positive focus 15.88±4.07 6~24
     Coping 10.30±2.95 5~20
     Planning 6.30±2.35 3~12
    Social support 40.93±7.96 12~60
     Significant others 10.61±4.71 4~20
     Family 16.40±2.66 4~20
     Friends 13.91±3.46 4~20
    Resilience 99.10±12.36 27~135
     Cause analytical 11.36±1.82 3~15
     Emotion control 11.12±2.08 3~15
     Urges restraint 11.35±1.82 3~15
     Gratitude 11.15±2.26 3~15
     Life satisfaction 9.98±2.37 3~15
     Optimism 11.85±1.76 3~15
     Relationship 11.56±2.41 3~15
     Communication 10.09±2.38 3~15
     Empathy 10.64±2.03 3~15

    Difference in Posttraumatic Growth based on Sociodemographic and Disease related Characteristics (N=80)

    Characteristics Categories n (%) M±SD t or F p Scheffé
    Gender Male 46 (57.5) 50.5±13.65 -0.51 .611
    Female 34 (42.5) 51.1±14.73
    Age (year) ≤49a 19 (23.8) 58.6±10.34 4.01 .011 a>b
    50~59b 18 (22.5) 43.8±15.09
    60~69c 26 (32.5) 52.1±10.83
    ≥70d 17 (21.2) 49.2±17.17
    Marital status Single 6 (7.5) 48.7±3.33 2.58 .083
    Married 60 (75.0) 53.1±14.11
    Separation 14 (17.5) 44.0±14.70
    Number of children 0 12 (15.0) 49.0±12.12 1.64 .186
    1 9 (11.2) 42.9±18.48
    2 35 (43.8) 54.0±13.38
    ≥3 24 (30.0) 51.3±14.50
    Education completed ≤Middle schoola 20 (25.0) 49.8±13.37 3.48 .036 b<c
    High schoolb 38 (47.5) 48.2±13.72
    ≥Collegec 22 (27.5) 57.6±13.67
    Job No 56 (70.0) 51.1±14.72 0.04 .967
    Yes 24 (30.0) 51.3±12.64
    Income No 49 (61.3) 50.4±15.01 -0.59 .560
    Yes 31 (38.7) 52.3±12.32
    Religion No 24 (30.0) 48.6±15.09 0.65 .629
    Yes 56 (70.0) 52.3±13.57
    Importance of religion Not importanta 25 (31.3) 44.4±13.85 4.70 .012 a<b
    A little importantb 39 (48.8) 54.6±11.29
    Very importantc 16 (20.0) 53.3±17.22
    Character Extrovert 29 (36.3) 55.6±11.84 2.17 .033
    Introvert 51 (63.7) 48.6±14.82
    Cancer stage I 1 (1.3) 52.0 0.59 .621
    II 10 (12.5) 54.9±7.77
    III 44 (55.0) 49.3±14.29
    IV 25 (31.2) 52.8±15.67
    Therapy method Surgery 7 (8.8) 48.1±11.02 1.19 .320
    Surgery+chemo 52 (65.0) 49.6±14.27
    Surgery+chemo+radiation 19 (23.8) 56.2±13.92
    Other 2 (2.5) 55.0±16.97
    Ostomy Yes 10 (12.5) 49.2±13.39 0.01 .929
    No 70 (87.5) 51.4±14.21

    Correlational Relationships among Major Variables (N=80)

    Variables PTG PTG; Personal strength PTG; Relating to others PTG; New possibilities PTG; Spiritual change
    r (p) r (p) r (p) r (p) r (p)
    Coping .55 (<.001) .49 (.001) .49 (<.001) .58 (<.001) .31 (.005)
    Social support .34 (<.001) .36 (.001) .29 (.009) .26 (.018) .23 (.037)
    Resilience .42 (<.001) .52 (<.001) .40 (<.001) .33 (.003) .05 (.653)

    PTG=posttraumatic growth.

    Factors related to Posttraumatic Growth in Patients with Colorectal Cancer (N=80)

    Variable B SE β t p VIF
    Resilience 0.48 0.11 .46 5.18 <.001 1.187
    Coping 0.35 0.11 .34 3.82 <.001 1.224
    Importance of religion (A little important) 7.20 2.72 .19 2.31 .024 1.043
    Importance of religion (Very important) 4.98 3.33 .14 1.49 .139 1.398
    Age -0.05 0.12 -.04 -0.36 .718 1.606
    Education completed (High school) -3.25 2.95 -.12 -1.10 .274 1.707
    Education completed (College and above) 0.93 3.69 .03 0.25 .801 2.138
    Social support 0.01 0.17 .42 0.04 .967 1.407
    Adj. R2=.48.4, F=10.270, p<.001, Durbin-Watson=2.07
    Table 1. Status of Posttraumatic Growth and related Factors in Patients with Colorectal Cancer (N=80)

    Table 2. Difference in Posttraumatic Growth based on Sociodemographic and Disease related Characteristics (N=80)

    Table 3. Correlational Relationships among Major Variables (N=80)

    PTG=posttraumatic growth.

    Table 4. Factors related to Posttraumatic Growth in Patients with Colorectal Cancer (N=80)

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