Investigation of Structural Relationships of Factors Affecting Posttraumatic Growth in Women With Breast Cancer

• Main Authors: Azam Hashemian Moghadam, Hamid Reza Aghamohammadian Sharbaf, Mohammad Saeid AbdeKhodaei, Hossein Kareshki, Mona Joudi
• Format: Article
• Language: English
• Published: Shahid Beheshti School of Nursing and Midwifery, Rasht 2021-09-01
• Series: Journal of Holistic Nursing and Midwifery
• Subjects: posttraumatic growth; positive re-evaluation; re-evaluation; spirituality; religion; rumination
• Online Access: http://hnmj.gums.ac.ir/article-1-1742-en.html

Introduction: It is necessary to identify the factors affecting the posttraumatic growth of cancer patients to minimize the consequences of its psychological trauma.     Objective: This study aimed to determine the structural relationships of coping styles, the collapse of core beliefs, social support, spirituality/religious coping with posttraumatic growth variables, and the mediating role of positive reassessment and deliberate mental rumination within a causal pattern.  Materials and Methods: This cross-sectional study was performed using path analysis and structural equation modeling (SEM) by convenience sampling method on 213 patients with breast cancer in Mashhad, Iran, in 2019.  The pattern of variables relationships was tested in a conceptual model by SEM and used the partial least squares regression method to test the measurement pattern and research hypotheses.  In the measurement model section, three convergent validity indices, i.e., Average Variance Extracted (AVE), Composite Reliability (CR), and the Cronbach α, and in the structural model section, two indicators of coefficient of determination (R2) and Stone-Geisser coefficient (Q²).  Results: The Mean±SD age of the patients was 52±16 years. The standardized coefficients of the overall effect of core beliefs pathways, positive religious coping, search for meaning, presence of meaning, deliberate rumination over positive re-evaluation were 0.953, 0.386, -0.250, 0.248, and 0.238, respectively (P=0.001).  The direct coefficient of the positive reassessment path to posttraumatic growth was 0.085 (P=0.01). Also, the coefficient of collapse path of core beliefs to intrusive rumination was 0.687, which was significant at the level of P=0.0001.  Finally, the standardized coefficients of the overall effect of all paths for negative religious coping, the collapse of core beliefs, presence of meaning, problem-based coping style, search for meaning, deliberate rumination, social support, positive religious coping, emotion-based coping, intrusive rumination over posttraumatic growth were -0.481, 0.227, 0.182, 0.146, -0.136, 0.066, 0.060, 0.059, 0.056, and -0.043, respectively (P=0.0001). Conclusion: The results of the present study showed that in addition to confirming the direct paths of independent variables to the posttraumatic growth, positive reassessment had a mediating role between pathways of the presence and search of meaning, conscious rumination, religious coping, and the collapse of core beliefs in posttraumatic growth.