Benefit finding, posttraumatic growth and health-related quality of life in long-term cancer survivors: a prospective population-based study

Figures & data

Table 1. Baseline characteristics of samples at baseline study and follow-up study.

	Sample at baseline (N = 6057)		Sample at follow-up (N = 2704)
	N	%^a	N	%^a
Sex
Male	2899	47.9	1266	46.8
Female	3158	52.1	1438	53.2
Age at baseline (years)
34–49	242	4.0	127	4.7
50–59	683	11.3	425	15.7
60–69	1786	29.5	965	35.7
70–79	2734	45.1	1102	40.8
80–89	611	10.1	85	3.1
Missing	1	0.0	–	–
Education (years)
≤9	3162	52.2	1260	46.6
10–11	1416	23.4	699	25.9
≥12	1359	22.4	719	26.6
Missing	120	2.0	26	1.0
Cancer type at diagnosis
Breast	2654	43.8	1231	45.5
Colorectal	1217	20.1	507	18.8
Prostate	2186	36.1	966	35.7
UICC stage at diagnosis
I–II	3712	61.3	1757	65.0
III–IV	1183	19.5	501	18.5
Missing	1162	19.2	446	16.5
Years since diagnosis
5–9	4824	79.6	2224	82.3
10–16	1192	19.7	474	17.5
Missing	41	0.7	6	0.2
Comorbidity^b
None	1545	25.5	767	28.4
1	1561	25.8	735	27.2
≥2	2938	48.5	1201	44.4
Missing	13	0.2	1	0.0
Active cancer disease^c
Yes (any)	759	12.5	260	9.6
No	5036	83.1	2337	86.4
Missing	262	4.3	107	4.0
Benefit finding
None-to-low	2111	34.9	970	35.9
Moderate-to-high	3840	63.4	1708	63.2
Missing	106	1.8	26	1.0
Posttraumatic growth
None-to-low	4828	79.7	2168	80.2
Moderate-to-high	1129	18.6	518	19.2
Missing	100	1.7	18	0.7

Note. ^a% column might not add up to 100% due to rounding up of decimals.

^bComorbidities include stroke, heart attack, coronary heart disease, heart failure, arthrosis, rheumatism, osteoporosis, diabetes, depression, and ‘other’ diseases.

^cActive cancer disease is defined as any recurrence, metastasis, or new primary cancer after index cancer.

Table 2. Tests of effects on longitudinal relationship between benefit finding and health-related quality of life (functional scales and global health status/QOL of EORTC QLQ-C30).

Outcome	Estimate	t	p
Physical functioning
BF groups	1.46	2.37	0.02
Study time interval	−0.73	−13.00	<0.001
BF Groups × Study time interval	0.06	0.63	0.53
Role functioning
BF groups	2.86	2.87	0.004
Study time interval	−0.42	−4.55	<0.001
BF Groups × Study time interval	−0.004	−0.03	0.98
Emotional functioning
BF groups	1.40	1.49	0.14
Study time interval	0.36	4.92	<0.001
BF Groups × Study time interval	0.01	0.50	0.96
Cognitive functioning
BF groups	1.09	1.37	0.17
Study time interval	0.02	0.36	0.72
BF Groups × Study time interval	−0.10	−1.03	0.31
Social functioning
BF groups	3.57	3.51	<0.001
Study time interval	0.15	1.94	0.05
BF Groups × Study time interval	−0.09	−0.73	0.47
Global health status/quality of life
BF groups	−0.22	−0.27	0.79
Study time interval	0.18	2.53	0.01
BF Groups × Study time interval	0.13	1.15	0.25

Note. ‘BF groups’: none-to-low benefit finding group compared to the moderate-to-high benefit finding group (reference). BF: benefit finding. Bold values indicate p < 0.05.

Table 3. Tests of effects on longitudinal relationship between posttraumatic growth and health-related quality of life (functional scales and global health status/QOL of EORTC QLQ-C30).

Outcome	Estimate	t	p
Physical functioning
PTG groups	−0.15	−0.20	0.84
Study time interval	−0.74	−7.49	<0.001
PTG Groups × Study time interval	0.04	0.35	0.73
Role functioning
PTG groups	−1.66	1.39	0.17
Study time interval	−0.49	−3.06	0.002
PTG Groups × Study time interval	0.09	0.52	0.61
Emotional functioning
PTG groups	0.31	0.27	0.79
Study time interval	0.24	1.87	0.06
PTG Groups × Study time interval	0.16	1.15	0.25
Cognitive functioning
PTG groups	−0.59	−0.61	0.54
Study time interval	−0.05	−0.48	0.63
PTG Groups × Study time interval	0.05	0.43	0.67
Social functioning
PTG groups	0.90	0.73	0.47
Study time interval	0.17	1.32	0.19
PTG Groups × Study time interval	−0.06	−0.45	0.66
Global health status/quality of life
PTG groups	−3.12	−3.08	0.002
Study time interval	0.02	0.16	0.88
PTG Groups × Study time interval	0.25	1.96	0.50

Note. ‘PTG groups’ means the none-to-low posttraumatic growth group compared with the moderate-to-high posttraumatic growth group (reference). PTG: posttraumatic growth. Bold values indicate p < 0.05

Figure 1. Distribution of HRQOL scores in none-to-low and moderate-to-high BF group (upper line) and the differences of HRQOL between none-to-low and moderate-to-high BF (lower line). Note. HRQOL: health-related quality of life; BF: benefit finding. PF: physical functioning; EF: emotional functioning; CF: cognitive functioning; RF: role functioning; SF: social functioning; QL: the global health status/quality of life. LowerCL/upperCL: lower level/upper level of 95% confidence interval on the HRQOL difference between none-to-low group and moderate-to-high BF group. Baseline HRQOL was adjusted for cancer type, sex, age at survey, education, time since diagnosis, UICC stage, comorbidities, and active cancer disease. Follow-up HRQOL was adjusted for baseline HRQOL, other baseline variables (cancer type, sex, education, UICC stage), and follow-up variables (age at survey, time since diagnosis, comorbidities, and active cancer disease).

Figure 2. Distribution of HRQOL scores in none-to-low and moderate-to-high PTG group (upper line) and the differences of HRQOL between none-to-low and moderate-to-high PTG (lower line). Note. HRQOL: health-related quality of life; PTG: posttraumatic growth. PF: physical functioning; EF: emotional functioning; CF: cognitive functioning; RF: role functioning; SF: social functioning; QL: the global health status/quality of life. LowerCL/upperCL: lower level/upper level of 95% confidence interval on the HRQOL difference between none-to-low group and moderate-to-high PTG group. Baseline HRQOL was adjusted for cancer type, sex, age at survey, education, time since diagnosis, UICC stage, comorbidities, and active cancer disease. Follow-up HRQOL was adjusted for baseline HRQOL, other baseline variables (cancer type, sex, education, UICC stage), and follow-up variables (age at survey, time since diagnosis, comorbidities, and active cancer disease).

Data availability statement

Due to the nature of the research, ethical supporting data are not available.