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Distress mediates the relationship between cognitive appraisal of medical care and benefit finding/posttraumatic growth in long‐term cancer survivors
Author(s) -
Liu Zhunzhun,
Doege Daniela,
Thong Melissa S. Y.,
KochGallenkamp Lena,
Bertram Heike,
Eberle Andrea,
Holleczek Bernd,
Nennecke Alice,
Waldmann Annika,
Zeißig Sylke Ruth,
Pritzkuleit Ron,
Arndt Volker
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33684
Subject(s) - moderation , medicine , distress , cognitive appraisal , clinical psychology , posttraumatic growth , population , cognition , cancer , psychiatry , psychology , social psychology , environmental health
Background The objective of this study was to ascertain long‐term cancer survivors' (LTCS') appraisal of medical care and how these perceptions may influence their health and well‐being, including benefit finding (BF) and posttraumatic growth (PTG). Methods In total, 6952 LTCS from a multiregional population‐based study in Germany completed the Benefit Finding Scale, the Posttraumatic Growth Inventory, the Questionnaire on Stress in Cancer, and self‐designed questions on cognitive appraisal of medical care. The authors explored the mediating role of distress between medical care appraisal and BF and PTG and the possible moderation of time since diagnosis in this relationship. RESULTS LTCS' medical care appraisals (“no unresolved/untreated symptoms,” “satisfaction with cancer care,” and “satisfaction with care for other diseases”) were positively associated with BF. PTG was positively associated with “no unresolved/untreated symptoms” and negatively associated with “satisfaction with care for other diseases.” Cancer distress partially mediated the associations between appraisals of medical care and BF, between “no unresolved/untreated symptoms” and PTG and between “satisfaction with care for other diseases” and PTG; whereas it totally mediated the association between “satisfaction with cancer care” and PTG. Time was a significant moderator in the model; the negative indirect effect of cognitive appraisal on BF and PTG through cancer distress weakened with longer time since diagnosis. Conclusions Cancer survivors' medical care appraisal is associated with their perceptions of BF and PTG through distress. Therefore, distress screening could be part of the regular workup to identify distressed cancer survivors who are not satisfied with medical care; these survivors may benefit from interventions to reduce distress and increase BF and PTG.