title: Positive changes among patients with advanced colorectal cancer and their family caregivers: a qualitative analysis.
abstract: This study assessed positive changes in patients with advanced colorectal cancer and their family caregivers following diagnosis. We compared self-reported positive changes within patient-caregiver dyads as well as self-reports and patient reports of positive changes in caregivers.
  
  
  
  Individual, semi-structured qualitative interviews were conducted with 23 patients with advanced colorectal cancer and 23 caregivers. A theoretical thematic analysis of interview transcripts was framed by posttraumatic growth theory.
  
  
  
  Patients and caregivers described five positive changes: closer relationships with others, greater appreciation of life, clarifying life priorities, increased faith, and more empathy for others. Additionally, only caregivers reported better health habits following the cancer diagnosis, and a minority of patients and caregivers reported no positive changes. In about half of cases, patients reported at least one positive change that was identical to that of their caregiver. However, in most cases, patient and caregiver reports of the caregiver's positive change were discrepant.
  
  
  
  Findings suggest that positive changes are a shared experience for many patient-caregiver dyads and obtaining both patient and caregiver reports of caregiver positive changes provides a more comprehensive understanding of their experience. Interventions may capitalise on positive changes to promote meaningful living in the context of advanced cancer.
authors: a Department of Psychology , Indiana University-Purdue University Indianapolis , Indianapolis , IN , USA.
authors: Catherine E
authors: CE
authors: Mosher
authors: b Department of Pediatrics , Stanford University School of Medicine , Palo Alto , CA , USA.
authors: Rebecca N
authors: RN
authors: Adams
authors: c Department of Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.
authors: Paul R
authors: PR
authors: Helft
authors: c Department of Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.
authors: Bert H
authors: BH
authors: O'Neil
authors: c Department of Medicine , Indiana University School of Medicine , Indianapolis , IN , USA.
authors: Safi
authors: S
authors: Shahda
authors: d Center for Health Information and Communication , Richard L. Roudebush VA Medical Center , Indianapolis , IN , USA.
authors: Nicholas A
authors: NA
authors: Rattray
authors: e Department of Community and Health Systems , Indiana University School of Nursing , Indianapolis , IN , USA.
authors: Victoria L
authors: VL
authors: Champion
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D036301:Qualitative Research; D057566:Self Report
keywords: benefit finding; colorectal cancer; family caregivers; positive changes; posttraumatic growth; qualitative