Correlated factors of posttraumatic growth in patients with colorectal cancer: A systematic review and meta-analysis.
Dingyuan Wei, Xue Wang, Mengxing Wang and 4 others
PMID 39990990WHAT IT FOUND
Posttraumatic growth in colorectal cancer survivors was linked to psychosocial factors: social support, resilience and confrontation coping went with higher growth; stigma and avoidance coping went with lower growth.
Sex, age, anxiety and depression were not linked.
Key findings
01PTG was positively correlated with confrontation coping (r = 0.68), deliberate rumination (r = 0.56), resilience (r = 0.53), family function (r = 0.50), social support (r = 0.47) and self-efficacy (r = 0.91, 2 studies), and negatively correlated with avoidance coping (r = -0.65) and stigma (r = -0.65).
02PTG was positively correlated with urban residence (r = 0.13), being married (r = 0.10), being employed (r = 0.18), education level (r = 0.19), income level (r = 0.16), time since surgery (r = 0.17) and stoma-related complications (r = 0.14).
03PTG was not significantly correlated with sex (r = 0.05), age (r = -0.06), religious beliefs (r = 0.30), time since diagnosis (r = 0.19), acceptance coping (r = -0.19), intrusive rumination (r = -0.37), anxiety (r = -0.11) or depression (r = -0.14).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, so they show links, not cause. You cannot conclude that improving social support, resilience or coping will increase PTG. Many pooled correlations had high heterogeneity, and some changed or became unstable when individual studies were removed in sensitivity analysis. Most studies were conducted in China, so the pattern may not apply to other cultures or healthcare settings. Some factors rested on very few studies, including self-efficacy (2 studies), fear of cancer recurrence (2 studies), self-perceived burden (2 studies), family function (3 studies) and anxiety or depression (3 studies). PTG scores varied widely across studies, from 13.70 to 89.60, and factors were measured with 28 tools. All included studies were moderate or high quality by the checklists used, but the three cohort studies scored 4 on the Newcastle-Ottawa Scale. The Discussion says stoma-related complications were associated with less PTG, but the pooled correlation was positive (r = 0.14).
Declared interests
The study was funded by a Zhejiang University Double First-Class discipline project. The funder had no role in study design, data collection and analysis, decision to publish, or manuscript preparation. The authors declared no conflict of interest.
The easy way to misread this
Do not read these correlations as proof that an intervention will increase posttraumatic growth. Most included studies were cross-sectional, so they cannot show cause and effect, and several pooled results changed when one study was removed.