Are Posttraumatic Stress Symptoms and Avoidant Coping Inhibitory Factors? The Association Between Posttraumatic Growth and Quality of Life Among Low-Grade Gliomas Patients in China

Abstract

Background: Diagnosing with low-grade gliomas (LGGs) can be a very shocking and stressful experience, a traumatic event potentially leading to the development of posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Understanding how patients cognitively and behaviorally response to their diagnosing is also important to postoperative treatment. Thus, the current study explored the association between PTG and quality of life (QoL) of Chinese patients with LGGs. The moderation effects of coping strategies and PTSS on the relationship between PTG and QoL have been examined as well. Methods: Posttraumatic stress symptoms, Posttraumatic growth, coping strategies, and QoL were measured by using self-report surveys. Three hundred and thirty patients completed surveys approximately 1 month after surgery. We used three multiple regression models and added interaction terms in these models to test the moderation effects of PTSS and coping strategies on the relationship between PTG and QoL. Results: The results of hierarchical multiple regression suggested that PTG significantly predicted QoL, both PTSS and coping strategies moderated the association between PTG and QoL. Specifically, the association between PTG and QoL for patients who have non-significant PTSS is stronger than those who have significant PTSS. Furthermore, as the score of Avoidant Coping increases, the association between PTG and QoL becomes weaker. Conclusion: Posttraumatic growth may help to improve the QoL of LGGs patients, but PTSS and Avoidant Coping impeded the positive effect of PTG on QoL.

Health-related quality of life in adults with low-grade gliomas: a systematic review

“…Greater processing speed was significantly associated with more suffering from headaches (P = 0.018), while greater verbal memory (P = 0.044), working memory (P = 0.036), and information processing (P = 0.018) were significantly associated with less suffering from headaches Campanella (2017) [35] No significant associations were observed Leonetti (2021) [45] Higher levels of language deficit were significantly associated with worse mental component scores at 6-months (P = 0.014) and 1-year post-surgery (P < 0.01), and worse physical component scores at 3-months (P = 0.025), 6-months (P = 0.049), and 1-year post-surgery (P = 0.014) Ruge (2011) [49] Better divided attention performance was significantly associated with better general health perception (P < 0.02) and less bodily pain (P < 0.05) Coping − Gustafsson (2006) [40] Higher levels of avoidant coping were significantly associated with worse emotional functioning (P < 0.01). Higher confrontive coping was significantly associated with greater financial impact (P < 0.01) and worse role functioning (P < 0.01) Li (2019) [56] Higher levels of avoidant coping were significantly associated with worse global HRQoL (P < 0.01) Depression − Ruge (2011) [49] Higher levels of depression were significantly associated with worse vitality (P < 0.01), social functioning (P < 0.01), emotional functioning (P < 0.05) and mental health (P < 0.01) Wang (2018); Li (2019) [54,55] a Higher levels of depression were significantly associated with worse global HRQoL (P < 0.01) Duration of symptoms − Ruge (2011) [49] Longer duration of symptoms (> 20 weeks) was associated with worse physical functioning (P = 0.043), vitality (P = 0.023), social functioning (P = 0.036), and emotional role functioning (P = 0.014) [12] No significant associations were observed Budrukkar (2009) [34] Higher level of literacy was significantly associated with better global HRQoL (P = 0.025) Campanella (2017) [35] No significant associations were observed Leonetti (2021) [45] No significant associations were observed Epilepsy/seizure burden − Aaronson (2011) [12] Higher epilepsy burden was significantly associated with worse physical and mental component scores, and higher levels of future uncertainty, motor dysfunction, communication deficit, seizures (all P < 0.01), visual disorder (P = 0.019), suffering from headaches (P = 0.046), drowsiness (P = 0.033), and weakness of legs (P = 0.021) Campanella (2017) [35] Higher epilepsy burden was significantly associated with worse psychological wellbeing (P = 0.013) Klein (2003) [44] Higher epilepsy burden was significantly associated with worse physical health and m...…”

“…Radiotherapy was significantly associated with worse mental component scores (P = 0.029) Budrukkar (2009) [34] No significant associations were observed Campanella (2017) [35] No significant associations were observed Drewes (2018) [38] No significant associations were observed Leonetti (2021) [45] Receipt of adjuvant treatments was significantly associated with worse mental component scores at 6-months postsurgery (P < 0.01) and worse physical component scores at 3-months (P = 0.013) and 6-months post-surgery (P < 0.01) Okita (2015) [47] Radiotherapy was significantly associated with lower levels of nausea and vomiting (P = 0.01) and dyspnoea (P = 0.04), but higher levels of communication deficit (P = 0.03). Chemotherapy was significantly associated with worse physical functioning (P = 0.05) and bladder control (P = 0.04) Wang (2018); Li (2019) [54,56] a No significant associations were observed Yavas (2012) [57] No significant associations were observed were examined. Overall, the evidence-base suggests global HRQoL in LGG patients is poor, with considerable functioning impairments and symptom burden, most notably, cognitive functioning and fatigue, respectively.…”

“…Studies were conducted across 13 countries: three each in the Netherlands [12, 30-32, 44, 48] and USA [33,36,37,39], two each in China [42,[54][55][56], Italy [35,45], India [34,46], Japan [47,53], and Norway [38,41], and one each in Australia [52], Finland [50,51], Germany [49], South Korea [43], Sweden [40], and Turkey [57] (Table 1; Supplementary Table S3). Sample size ranged from 15 to 260.…”

“…The 29 papers identified relating to 22 studies were largely good quality. Thirteen studies included comparator and/or control groups, and 19 factors Older age was significantly associated with worse visual disorder (P = 0.039) Budrukkar (2009) [34] No significant associations were observed Campanella (2017) [35] No significant associations were observed Gustafsson (2006) [40] No significant associations were observed Leonetti (2021) [45] No significant associations were observed Okita (2015) [47] Older age (≥ 40) was significantly associated with lower levels of diarrhoea (P = 0.05) Ruge (2011) [49] No significant associations were observed Wang (2018); Li (2019) [54,56] a No significant associations were observed Cognitive function * Boele (2014) [30] Greater executive functioning, processing speed, verbal memory, working memory, information processing, and attention were significantly associated with lower levels of future uncertainty (all P < 0.01), visual disorder (all P < 0.01; verbal memory P = 0.011), motor dysfunction (all P < 0.01), communication deficit (P < 0.01; verbal memory P = 0.011; executive functioning P = 0.034; processing speed not significant), and less seizures (all P < 0.01), and drowsiness (processing speed and information processing P < 0.01; executive functioning P = 0.014; verbal memory P = 0.029; working memory P = 0.011; attention not significant). Greater processing speed was significantly associated with more suffering from headaches (P = 0.018), while greater verbal memory (P = 0.044), working memory (P = 0.036), and information processing (P = 0.018) were significantly associated with less suffering from headaches Campanella (2017) [35] No significant associations were observed Leonetti (2021) [45] Higher levels of language deficit were significantly associated with worse mental component scores at 6-months (P = 0.014) and 1-year post-surgery (P < 0.01), and worse physical component scores at 3-months (P = 0.025), 6-months (P = 0.049), and 1-year post-surgery (P = 0.014) Ruge (2011) [49] Better divided attention performance was significantly associated with better general health perception (P < 0.02) and less bodily pain (P < 0.05) Coping − Gustafsson (2006) [40] Higher levels of avoidant coping were significantly associated with worse emotional functioning (P < 0.01).…”

Posttraumatic Growth and Coping Strategies Among Patients With Head and Neck Cancer: Do Approach Coping and Avoidant Coping Predict Posttraumatic Growth Over Time?

“…Unsurprisingly, a higher degree of coping by denial lowered the degree of PTG among HNC survivors over time. There is a growing body of literature indicating that avoidant coping contributes to lower degree of PTG among cancer patients ( Kroemeke et al, 2017 ; Li et al, 2019 ). Denial about having cancer and cancer’s negative consequences may have occurred at a higher degree immediately after cancer diagnoses.…”