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Supportive Care in Cancer

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Open Access 01-02-2019 | Original Article

Positive mental health among cancer survivors: overlap in psychological well-being, personal meaning, and posttraumatic growth

Authors: K. Holtmaat, N. van der Spek, B. I. Lissenberg-Witte, P. Cuijpers, I. M. Verdonck-de Leeuw

Published in: Supportive Care in Cancer | Issue 2/2019

Abstract

Purpose

Positive mental health involves theoretical constructs like psychological well-being, personal meaning, and posttraumatic growth. This study aims to provide empirical insight into possible overlap between these constructs in cancer survivors.

Methods

Within the context of a randomized controlled trial, 170 cancer survivors completed the patient-reported outcome measures (PROMs) Ryff’s Scales of Psychological Well-Being (SPWB), Personal Meaning Profile (PMP), and Posttraumatic Growth Inventory (PTGI). Exploratory factor analysis (EFA) on the subscales of these PROMs, as well as structural equation modeling (SEM), was used to explore overlap in these three constructs.

Results

The EFA resulted in a three-factor solution with an insufficient model fit. SEM led to a model with a high estimated correlation (0.87) between SPWB and PMP and lower estimated correlations with PTGI (respectively 0.38 and 0.47). Furthermore, the estimated correlation between the subscales relation with God (PMP) and spiritual change (PTGI) was high (0.92). This model had adequate fit indices (χ²(93) = 144, p = .001, RMSEA = 0.059, CFI = 0.965, TLI = 0.955, SRMR = 0.061).

Conclusions

The constructs psychological well-being and personal meaning overlap to a large extent in cancer survivors. Posttraumatic growth can be seen as a separate construct, as well as religiosity. These findings facilitate researchers to select the appropriate PROM(s) when testing the effect of a psychosocial intervention on positive mental health in cancer survivors.

Relevance

An increasing number of psychosocial intervention trials for cancer survivors use positive mental health outcomes. These constructs are often multifaceted and overlapping. Knowledge of this overlap is important in designing trials, in order to avoid the pitfalls of multiple testing and finding artificially strengthened associations.

Netherlands Trial Register

NTR3571

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Title: Positive mental health among cancer survivors: overlap in psychological well-being, personal meaning, and posttraumatic growth
Authors: K. Holtmaat
N. van der Spek
B. I. Lissenberg-Witte
P. Cuijpers
I. M. Verdonck-de Leeuw
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 2/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4325-8

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Abstract

Purpose

Methods

Results

Conclusions

Relevance

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