Figure 1 Thematic framework of postoperative PTG in thyroid cancer
patients
2.3PTG-promoting factors in thyroid cancer patients
Some studies have shown that cognitive processing, positive coping
strategies, and high-quality support are all facilitators of
PTG(Barskova T et al.2009).
2.3.1Cognitive processing
Ending Reflection:After diagnosis, patients often reflect on the
causes of their illness and gain strength in the face of
adversity.P7:”I think I have this disease may be related to my love
of sulking and impatient nature.”
(2)Disclosure:After the illness, the patient will communicate and
confide in others in order to achieve a positive outcome in the
trauma.P8:”I was uncomfortable in my heart and told my wife, and
after that I was much more comfortable.”
2.3.2Positive coping strategies
Downward comparison:Patients engage in psychological self-protection
through comparison, resulting in greater gratitude for the present
moment.P2:”In fact, I think I am very lucky that this thyroid cancer
is so much better than other cancers.”
Focus on the present:Patients who have experienced the trauma of
thyroid cancer are more inclined to focus on the present moment and
promote post-traumatic growth in a range of ways.P13:”The epidemic
has slowed down the city, so I can finally slow down a little bit too.
In the future, emotions must be controlled and relaxed when things go
wrong.”
2.3.3High quality support
Support from medical and nursing staff:Health care professionals
contribute to the occurrence of post-traumatic growth by providing
knowledge support, therapeutic care support, and psychological support
to patients.P1:”The doctors and nurses at your hospital were very
nice and gave me a very friendly feeling, which made me feel much more
comfortable.”Currently, the Internet has become the safest and most
convenient channel for patients to consult and seek medical treatment,
breaking the spatial limitation between doctors and patients and
accelerating the post-traumatic growth of patients.P7:”The epidemic
made everything inconvenient, but fortunately doctor built a group
chat, I forgot to take Levothyroxine last time,so I asked him in the
group chat what to do, and he soon replied to me.”
(2)Support from family members:Family support, a major support system,
has a sustained positive contribution to post-traumatic growth in
thyroid cancer patients.P13:”Since being hospitalized, my daughter
often cares about me through WeChat, and my lover has learned to cook
and wash clothes by herself when I am not at home, which is quite
gratifying.”
(3)Peer Support:During a patient’s visit, the support and encouragement
of the patient’s friends are an important factor in contributing to the
patient’s post-traumatic growth.P1:”Before the surgery, I was very
nervous and couldn’t sleep, so the aunt in the bed next to me kept
comforting me and encouraging me.”
2.4 Post-traumatic growth experience for thyroid cancer patients
2.4.1Personal changes
(1)Life Philosophy Change:Affected by the trauma of the disease, the
patient re-examines the meaning of life.P13:I used to save money for my
family and come here to work hard, but now I have some money in my hand,
but my health is broken. My daughter says it’s best for the family to be
healthy and safe.”
(2)Self-efficacy Enhancement:Self-efficacy is an important part of the
patient’s growth from trauma and belongs to the category of positive
psychological activity(Lotfi-Kashani F et al.2014).Patients see the
traumatic event of thyroid cancer as a life path exercise and feel more
confident to tackle future challenges.P1:”I used to think I was
fragile, but I’ve really come through this.”
(3)Envisioning a New Life:Although the patients experienced the trauma
of thyroid cancer, they still had hope for their future lives,
indicating that the traumatic event brought real benefits and growth to
the patients.P1:”Now that medicine is so advanced, the epidemic will
pass, and by the time I’m feeling better, I’ll be able to have a baby.
(smile)”
2.4.2Changes in relationships with others
(1)More harmonious family relationships:After experiencing the traumatic
event of thyroid cancer, patients feel warmth from family members as
well as others, which is an important experience for post-traumatic
growth.P15:”I used to be so busy at work that I rarely had time to chat
with my parents for a long time, but now that I’m in the hospital, I can
video chat with them every day, which is a blessing in
disguise.”P13:“Since being hospitalized, my daughter often cares
about me through WeChat. If I wasn’t sick, there are some things she
wouldn’t say to me.”
(2)Increased empathy:Because patients have experienced the pain of a
traumatic event, they are more likely to develop empathy for others on
top of that.P7:”I can’t understand the pain of surgery when I’m not
sick, but now I can feel it… I will cheer up my friends who are going
to have surgery around me.”
(3)Judgmental psychology is reduced:Respondents generally reported that
the experience of thyroid cancer as a disease had made them more
tolerant of others and less judgmental of their behavior.P7: ”After I
got sick, I was a lot less judgmental of others.We are all carrying a
lot of weight with the epidemic, and we all have our own difficulties,
so we need more tolerance and understanding.”