title: Examining the links between perceived impact of breast cancer and psychosocial adjustment: the buffering role of posttraumatic growth.
abstract: OBJECTIVE
  Finding positive changes in the aftermath of breast cancer (BC) may protect women against impaired adjustment. This study examines posttraumatic growth (PTG) in a sample of women receiving treatment for BC and explores the buffering role of PTG on the links between perceived impact of BC and emotional distress and quality of life (QoL).
  
  
  METHODS
  Seventy-eight women receiving chemotherapy (n = 57) or radiotherapy (n = 21) completed the Portuguese versions of the Posttraumatic Growth Inventory, the Hospital Anxiety and Depression Scale, the World Health Organization for QoL-Bref and Consequences sub-scale of the Brief Illness Perception Questionnaire (assessing perceived impact of BC).
  
  
  RESULTS
  PTG was frequently reported and co-existed with distress and dysfunction. A more negative perception of the impact of BC was significantly associated with higher emotional distress and impaired Physical and Psychological QoL, but was unrelated to PTG. Hierarchical regression analyses showed that PTG moderated these relationships, acting as a stress-buffering mechanism. Among women who perceived BC as having a more negative impact on their lives, higher levels of PTG buffered this negative perceived impact on Psychological and Social QoL (p<0.01) and also on Depression (p<0.06). This effect was not found for Physical QoL and Anxiety.
  
  
  CONCLUSIONS
  Results provide support for the stress-buffering role of PTG. Finding positive changes in cancer experience seems to protect women from the effects of a negative perception of the impact of BC on adjustment. Psychosocial intervention programs should facilitate PTG in order to promote women's adjustment.
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal. soniaimsilva@gmail.com
authors.forename: Sónia Martins
authors.initials: SM
authors.lastname: Silva
authors.forename: Helena Cruz
authors.initials: HC
authors.lastname: Moreira
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Canavarro
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety; D001290:Attitude; D001943:Breast Neoplasms / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life; D012917:Social Adjustment; D013315:Stress, Psychological; D014947:Wounds and Injuries / Q000523:psychology