Posttraumatic growth and demoralization after cancer: The effects of patients' meaning-making

Palliat Support Care. 2015 Oct;13(5):1449-58. doi: 10.1017/S1478951515000048. Epub 2015 Mar 5.

Abstract

Objective: It is common for patients to experience positive and negative psychological changes (e.g., posttraumatic growth or demoralization) after being diagnosed with cancer. Although demoralization and posttraumatic growth are both related to meaning-making, little attention has been paid to the associations among these concepts. The current study investigated the relationship between demoralization, posttraumatic growth, and meaning-making (focusing on sense-making and benefit-finding during the experience of illness) in cancer patients.

Method: Some 200 cancer patients (with lung cancer, lymphoma, or leukemia) at the MacKay Memorial Hospital in New Taipei completed the Demoralization Scale-Mandarin Version (DS-MV), the Chinese Posttraumatic Growth Inventory (CPTGI), and a self-designed questionnaire for assessing sense-making and benefit-finding.

Results: Demoralization was negatively correlated with posttraumatic growth, sense-making, benefit-finding, and time-since-diagnosis. Multiple regression analysis showed that meaning-making had different effects on demoralization and posttraumatic growth. The interactions of sense-making with either benefit-finding or time-since-diagnosis significantly predicted demoralization. Individuals with relatively higher sense-making and benefit-finding or shorter time-since-diagnosis experienced less demoralization.

Significance of results: The suffering of cancer may turn on the psychological process of demoralization, posttraumatic growth, and meaning-making in patients. Cancer patients who evidenced higher posttraumatic growth experienced less demoralization. Trying to identify positive changes in the experience of cancer may be a powerful way to increase posttraumatic growth. As time goes by, patients experienced less demoralization. Facilitating sense-making can have similar effects. Cancer patients with less benefit-finding experience higher demoralization, but sense-making buffers this effect.

Keywords: Cancer; Demoralization; Meaning-making; Posttraumatic growth.

MeSH terms

  • Adult
  • Aged
  • Depressive Disorder / etiology
  • Depressive Disorder / psychology*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Regression Analysis
  • Resilience, Psychological*
  • Survivors / psychology*
  • Taiwan
  • Young Adult