title: Cancer's positive flip side: posttraumatic growth after childhood cancer.
abstract: BACKGROUND
  Surviving childhood cancer may result in positive psychological changes called posttraumatic growth (PTG). Knowing about the possibility of positive changes may facilitate survivors' reintegration in daily life. We aimed to (1) describe PTG in Swiss childhood cancer survivors including the most and the least common PTG phenomena on the subscale and item levels and (2) determine factors associated with PTG.
  
  
  METHODS
  Within the Swiss Childhood Cancer Survivor Study (SCCSS), we sent two questionnaires to childhood cancer survivors registered in the Swiss Childhood Cancer Registry (SCCR). Eligible survivors were diagnosed after 1990 at age ≤16 years, survived ≥5 years, and were aged ≥18 years at the time the second questionnaire was sent. We included the Posttraumatic Growth Inventory (PTGI) to assess five areas of PTG. We investigated the association of PTG with socio-demographic characteristics, self-reported late effects, and psychological distress, which were assessed in the SCCSS and clinical variables extracted from the SCCR. We used descriptive statistics to describe PTG and linear regressions to investigate factors associated with PTG.
  
  
  RESULTS
  We assessed PTG in 309 childhood cancer survivors. Most individuals reported to have experienced some PTG. The most endorsed change occurred in "relation with others," the least in "spiritual change." PTG was significantly higher in survivors with older age at diagnosis (p = 0.001) and those with a longer duration of treatment (p = 0.042), while it was lower in male survivors (p = 0.003).
  
  
  CONCLUSIONS
  Supporting experiences of PTG during follow-up may help survivors successfully return to daily life.
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
authors.forename: Micòl E
authors.initials: ME
authors.lastname: Gianinazzi
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
authors.forename: Corina S
authors.initials: CS
authors.lastname: Rueegg
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
authors.forename: Janine
authors.initials: J
authors.lastname: Vetsch
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology/Oncology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Lüer
authors.affiliation: Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Kuehni
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland. gisela.michel@unilu.ch.|Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. gisela.michel@unilu.ch.
authors.forename: Gisela
authors.initials: G
authors.lastname: Michel
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
keywords: Childhood cancer survivors; Cohort study; Posttraumatic growth; Questionnaire survey