Mediating roles of positive cognitive emotion regulation and sense of coherence in the relationship between family hardiness and post-traumatic growth among patients with lung cancer undergoing chemotherapy

Abstract

Background: Patients with lung cancer undergoing chemotherapy develop post-traumatic growth after a traumatic experience of lung cancer diagnosis and chemotherapy treatment, which is closely related to their quality of life. Although some studies have reported the effects of family hardiness (FH) on post-traumatic growth (PTG), the psychological mechanisms between them remain unclear. Therefore, this study aimed to investigate whether positive cognitive emotion regulation (PCER) and sense of coherence (SOC) mediate the relationship between FH and PTG in patients with lung cancer undergoing chemotherapy. Methods: A cross-sectional study was conducted on 321 patients with lung cancer who underwent chemotherapy between April and September 2022 at two hospitals in Shandong Province, China. Data were collected using the Family Hardiness Index (FHI), Cognitive Emotion Regulation Questionnaire (CERQ), Sense of Coherence Scale, and Post-Traumatic Growth Inventory (PTGI). Descriptive statistics, Pearson’s correlation, and mediation analyses were used. Results: PTG was positively associated with FH (r = 0.33, P < 0.01), PCER (r = 0.31, P < 0.01), and SOC (r = 0.37, P < 0.01). FH was positively associated with PCER (r = 0.31, P < 0.01) and SOC (r = 0.40, P < 0.01). PCER was positively associated with SOC (r = 0.32, P < 0.01). The mediation analysis showed that FH affected PTG (β = 0.250, P = 0.025) directly and indirectly through PCER and SOC (β = 0.093, 0.160, P < 0.05). The mediating effects of PCER and SOC accounted for 18.49% and 31.81%, respectively, of the total effect(FH→PTG). Conclusion: PCER and SOC mediated the relationship between FH and PTG in patients with lung cancer undergoing chemotherapy. Thus, future interventional studies should consider PCER and SOC as targets for developing post-traumatic growth in patients with lung cancer receiving chemotherapy.