[[alternative]]Posttraumatic growth and demoralization after cancer: The effects of patients’ meaning-making

[[abstract]]「罹患癌症」本身是一重大壓力源與創傷事件，當癌症病人在面對於疾病的威脅時可能感到失志（demoralization），亦可能在罹癌經驗的奮力因應中產生創傷後成長（posttraumatic growth，PTG）。這兩種心理歷程的發展可能跟病人如何從自己的癌症中發現意義有關。因此，本研究目的主要瞭解癌症病人失志、創傷後成長和發現意義的關聯性。研究參與者為200位的門診與住院的肺癌、白血病和淋巴癌的病人，在知情同意後完成問卷內容，包括：基本資料表、中文版失志量表(DS-MV)、創傷後成長量表（PTGI）、發現意義問題（對癌症的理解程度SM和生病後的正向改變BF）等問卷。結果發現，DS-MV與PTGI、SM(sense-making)、BF(benefit-finding)、罹病時間 (TSD，time since diagnosis)皆呈現顯著負相關。亦即若癌症病人在生病後的主觀感到創傷後成長較高，較能夠理解自己何以得癌症、從罹癌經驗中找到較多正向改變，甚至光是隨著時間越來越長，癌症病人的失志感受都會下降。然而對DS-MV的複回歸分析中也發現，SM × TSD和SM × BF的交互作用顯著。進一步分析的結果顯示，罹病時間較長的癌症病人失志較低，但是罹病時間較短的癌症病人若對自己生病的理解程度高，則其失志感受和罹病時間長的病人一樣低。第二個交互作用也呈現相似的模式，若癌症病人能從生病經驗中找到較多的正向改變，其失志程度較低；但是就算自覺的正向改變沒有那麼多，若病人對生病的理解程度高，其失志感受和前者一樣低。從研究結果可知促發病人試著對自己的生病產生個人意義的理解，並試著從生病經驗中發現個人的正向改變，有助於增進創傷後成長和降低失志。而交互作用的結果也發現，我們雖然無法加速時間或是太快地邀請病人去探索生病經驗中的正向改變，但依然可以藉由促發病人對於生病的理解，從中發現意義，而降低癌症病人的失志。[[abstract]]Background/Objectives: It’s common for cancer patients to experience positive and negative mental processes after diagnosis, such as post traumatic growth (PTG) or demoralization. Although demoralization and PTG are both related to meaning making, little attention has been paid to the correlation among these concepts. The current study attempted to investigate the relationship between demoralization, PTG, and meaning making (focusing on sense-making of cancer and benefit-finding in the experience) on cancer patients. Methods: A lung-cancer/lymphoma/leukemia sample of 200 patients in Mackay Memorial Hospital completed Demoralization Scale (DS-MV), Posttraumatic Growth Inventory (PTGI), and questions that assessed sense-making (SM) and benefit-finding (BF). Results: DS-MV was negatively correlated with PTGI, SM, BF, TSD (time since diagnosis). Multiple regression analysis showed that meaning-making has different effects on DS and PTG. The interactions SM × BF and SM × TSD was significant on DS, the higher SM the lower DS when BF or TSD are low.Conclusions: The suffering of cancer may turn on the mental process of demoralization, PTG, and meaning-making in patients. Ways to promote meaning-making of cancer patients to increase PTGI and buffer demoralization will be discussed