Details

Autor(en) / Beteiligte

• Liu, Zhunzhun
• Doege, Daniela
• Thong, Melissa S. Y.
• Koch‐Gallenkamp, Lena
• Bertram, Heike
• Eberle, Andrea
• Holleczek, Bernd
• Nennecke, Alice
• Waldmann, Annika
• Zeißig, Sylke Ruth
• Pritzkuleit, Ron
• Arndt, Volker

Titel

Distress mediates the relationship between cognitive appraisal of medical care and benefit finding/posttraumatic growth in long‐term cancer survivors

Ist Teil von

• Cancer, 2021-10, Vol.127 (19), p.3680-3690

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Background The objective of this study was to ascertain long‐term cancer survivors' (LTCS') appraisal of medical care and how these perceptions may influence their health and well‐being, including benefit finding (BF) and posttraumatic growth (PTG). Methods In total, 6952 LTCS from a multiregional population‐based study in Germany completed the Benefit Finding Scale, the Posttraumatic Growth Inventory, the Questionnaire on Stress in Cancer, and self‐designed questions on cognitive appraisal of medical care. The authors explored the mediating role of distress between medical care appraisal and BF and PTG and the possible moderation of time since diagnosis in this relationship. RESULTS LTCS' medical care appraisals (“no unresolved/untreated symptoms,” “satisfaction with cancer care,” and “satisfaction with care for other diseases”) were positively associated with BF. PTG was positively associated with “no unresolved/untreated symptoms” and negatively associated with “satisfaction with care for other diseases.” Cancer distress partially mediated the associations between appraisals of medical care and BF, between “no unresolved/untreated symptoms” and PTG and between “satisfaction with care for other diseases” and PTG; whereas it totally mediated the association between “satisfaction with cancer care” and PTG. Time was a significant moderator in the model; the negative indirect effect of cognitive appraisal on BF and PTG through cancer distress weakened with longer time since diagnosis. Conclusions Cancer survivors' medical care appraisal is associated with their perceptions of BF and PTG through distress. Therefore, distress screening could be part of the regular workup to identify distressed cancer survivors who are not satisfied with medical care; these survivors may benefit from interventions to reduce distress and increase BF and PTG. A major finding of this study is that cancer distress acts as a mediator in the association between cognitive appraisal of medical care and benefit finding (BF)/posttraumatic growth but that the negative indirect effect of cognitive appraisal of medical care on benefit finding and posttraumatic growth through perceived cancer distress weakens with longer time since diagnosis. These results highlight the necessity for health care providers to include screening for distress as part of the regular workup to identify at‐risk survivors.