title: Cancer patients' experience of positive and negative changes due to the illness: relationships with psychological well-being, coping, and goal reengagement.
abstract: OBJECTIVE
  Most studies in cancer patients on psychological changes focused on positive changes (so-called 'posttraumatic growth'), with surprisingly little attention on the possibility that patients may experience both positive and negative changes. This study investigated the relationship between positive and negative changes, and their association with positive and negative affect. We also examined the correlates of positive and negative changes, specifically the role of coping and goal reengagement.
  
  
  METHODS
  This cross-sectional study was conducted in 108 patients. We used Pearson correlations and Regression analyses to examine the research questions.
  
  
  RESULTS
  Positive and negative changes were relatively unrelated to each other. More positive changes were related to more positive affect, whereas more negative changes were related to more negative affect and less positive affect. Approach coping by more positive reappraisal and goal reengagement was significantly associated with more positive changes. More use of avoidant coping by self-distraction was related to more negative changes.
  
  
  CONCLUSIONS
  Patients experienced both positive and negative changes as a result of cancer. These changes were significantly related to patients' well-being, as well as to their coping and goal reengagement strategies. This knowledge may be incorporated in psychological interventions. Cancer patients can be assisted to learn to acknowledge both positive and negative changes in their life and to approach rather than avoid difficult situations. Patients may also be supported to engage in alternative meaningful goals in life. This is likely to help them find positive meaning.
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. M.J.Schroevers@med.umcg.nl
authors.forename: Maya J
authors.initials: MJ
authors.lastname: Schroevers
authors.forename: Vivian
authors.initials: V
authors.lastname: Kraaij
authors.forename: Nadia
authors.initials: N
authors.lastname: Garnefski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006040:Goals; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009426:Netherlands; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult