Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: A systematic review

Abstract

Purpose. The diagnosis of a life-threatening illness can be an extremely stressful, traumatic experience. However, many survivors report also various positive changes, referred in empirical literature as post-traumatic growth (PTG). Empirical studies that documented stress disorders and PTG in patients and survivors of life-threatening diseases are reviewed in three areas: Predictors of PTG, relationships between PTG and indicators of mental health and the impact of PTG on the process of convalescence.

Method. The literature review was completed by making use of three major databases – PsycINFO, PILOTS and Medline.

Results. The majority of the studies investigated PTG and its relationships to health indicators after the diagnosis of cancer, HIV/AIDS, cardiac disease, multiple sclerosis and rheumatoid arthritis. The review indicated that quality of social support, patients' coping strategies and several indicators of mental and physical health were consistently associated with post-traumatic growth. Associations between growth and health-related variables (e.g. physical deficits, pain, depression, anxiety) varied depending on different study design (cross-sectional versus longitudinal) and the sample composition (patients versus symptom-free survivors). Several findings are disease-specific.

Conclusions. The results point to the potential adaptive significance of PTG. More research is needed to investigate specific disease-related profiles of PTG and the complex mechanisms, which underlie the relationships between PTG and the process of convalescence. This knowledge may help to foster the overall positive adjustment of chronically ill patients.

Keywords:

• Post-traumatic growth
• physical health
• health behaviour
• coping
• rehabilitation

Notes

1. Common measures of functional disability (e.g. Stanford Health Assessment Questionnaire; Pincus et al. [89]) assess constraints in mobility and performance of daily living activities, like dressing, reaching and preparation of meals. Several instruments that measure functional disability also assess deficits in social and cognitive areas.