• Jennifer L Steel, T Clark Gamblin, and Brian I Carr.
• Department of Surgery, Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania, USA. steeljl@upmc.edu
• Oncol Nurs Forum. 2008 Jul 1; 35 (4): 643-50.

Purpose/ObjectivesTo highlight and provide preliminary data regarding issues in the measurement of post-traumatic growth in people diagnosed with primary or metastatic hepatobiliary cancer.DesignProspective.SettingA large medical center in Pittsburgh, PA.Sample120 patients with hepatobiliary cancer.MethodsParticipants were administered a battery of questionnaires, including the Post-Traumatic Growth Inventory (PTGI), Center for Epidemiological Studies-Depression scale, and the Functional Assessment of Cancer Therapy-Hepatobiliary module. Family caregivers also rated patients' post-traumatic growth. Qualitative data collected from patients included positive and negative changes associated with their cancer diagnoses.Main Research VariablesPost-traumatic growth, depression, quality of life, and caregiver ratings of patients' post-traumatic growth.FindingsThe results revealed that the PTGI is a reliable instrument in people diagnosed with cancer. The level of post-traumatic growth varies depending on hepatobiliary cancer type. The onset and process of post-traumatic growth differed based on the method of measurement employed (qualitative versus quantitative). Agreement on the PTGI was high between patients and caregivers, suggesting that the patients' growth was observable to others. Post-traumatic growth was not found to be associated with depressive symptoms, quality of life, or survival in patients diagnosed with hepatobiliary cancer.ConclusionsThe results of this study underscore the need to understand differences in the measurement and the process of post-traumatic growth in people with cancer.Implications For NursingFor some patients, post-traumatic growth as a result of a cancer diagnosis may be associated with positive cognitive, emotional, and behavioral changes that influence mental and physical health. For patients who experience post-traumatic growth, healthcare providers may be able to facilitate behavior changes to enhance health.

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