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Curvilinear prediction of posttraumatic growth on quality of life: a five-wave longitudinal investigation of breast cancer survivors

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Abstract

Purpose

Do cancer survivors experience positive changes (i.e., posttraumatic growth; PTG) resulting in better quality of life? The issue has yet to yield consistent notions. This longitudinal study extends the literature on the role of PTG by examining the curvilinear relationship between PTG and Health-Related Quality of Life (HRQoL), and explored whether PTG predicts subsequent HRQoL in a quadratic relationship across 2 years following surgery.

Methods

Women with breast cancer (N = 359; Mage = 47.5) were assessed at five waves over two years. On every measurement occasion, PTG measured by the posttraumatic growth inventory and HRQoL measured by SF-36 were assessed. The five waves reflect major medical demands and related challenges in the breast cancer trajectory, in which 1-day, 3 months, 6 months, 12 months, and 24 months after surgery were adopted as the survey timing. In a series of hierarchical linear modeling (HLM) analyses, the time-lagged predictions of PTG (i.e., linear, quadratic) on HRQoL were examined, controlling demographic and medical covariates.

Results

The results revealed that the quadratic term of PTG consistently significantly predicted physical and mental health quality of life (PCS and MCS), while the linear term of PTG did not significantly predict PCS or MCS.

Conclusion

With multi-wave longitudinal data, this study demonstrated that the relationship between PTG and HRQoL is curvilinear, and this finding extends to PTG’s prediction of subsequent HRQoL. The quadratic relationship has critical implications for clinical assessment and intervention. Details are discussed.

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Data availability

Data and material is available on reasonable request.

Code availability

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Funding

This work was supported by the National Science Council grant no. 99-2410-H-004-074-MY3.

Author information

Authors and Affiliations

  1. Department of Psychology, Soochow University, No.70, Linhsi Road, Shihlin District, Taipei, 111, Taiwan, ROC

    Ashley Wei-Ting Wang

  2. Department of Psychology, National Chengchi University, Taipei, Taiwan

    Wen-Yau Hsu

  3. Division of Hematology-Oncology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan

    Cheng-Shyong Chang

  4. Department of Health care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan

    Cheng-Shyong Chang

Authors
  1. Ashley Wei-Ting Wang
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  2. Wen-Yau Hsu
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Correspondence to Ashley Wei-Ting Wang.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was conducted in accordance with ethical guidelines and all procedures were approved by the Institutional Review Board of the Changhua Christian Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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All participants gave their written informed consent prior to participation.

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Wang, A.WT., Hsu, WY. & Chang, CS. Curvilinear prediction of posttraumatic growth on quality of life: a five-wave longitudinal investigation of breast cancer survivors. Qual Life Res 32, 3185–3193 (2023). https://doi.org/10.1007/s11136-023-03464-4

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  • DOI: https://doi.org/10.1007/s11136-023-03464-4

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