Impact of positive cognitive emotion regulation and sense of coherence in the relationship between family hardiness and post-traumatic growth in patients with lung cancer: a mediation analysis study in two tertiary hospitals of China

Abstract

Objectives: To investigate whether positive cognitive emotion regulation (PCER) and sense of coherence (SOC) mediate the relationship between family hardiness (FH) and post-traumatic growth (PTG) in patients with lung cancer undergoing chemotherapy.

Design: Cross-sectional study, convenience sampling method and mediation analyses.

Setting: All participants were from two hospitals in Shandong, China.

Participants: 321 patients with lung cancer who underwent chemotherapy between April and September 2022 at two hospitals in Shandong province, China.

Primary outcome measures: The Family Hardiness Index, Cognitive Emotion Regulation Questionnaire, Sense of Coherence Scale and Post-Traumatic Growth Inventory.

Results: PTG was positively associated with FH (r=0.33, p<0.01), PCER (r=0.31, p<0.01) and SOC (r=0.37, p<0.01). FH was positively associated with PCER (r=0.31, p<0.01) and SOC (r=0.40, p<0.01). PCER was positively associated with SOC (r=0.32, p<0.01). The mediation analysis showed that FH affected PTG (β=0.235, p<0.05) directly and indirectly through PCER and SOC (β=0.097, 0.142, p<0.05). The mediating effects of PCER and SOC accounted for 20.46% and 29.96%, respectively, of the total effect (FH → PTG).

Conclusion: PCER and SOC mediated the relationship between FH and PTG in patients with lung cancer undergoing chemotherapy. Thus, future interventional studies should consider PCER and SOC as targets for developing PTG in patients with lung cancer receiving chemotherapy.

Keywords: CHEMOTHERAPY; Lung Diseases; MENTAL HEALTH; Patients; Stress, Psychological.

Figure 1. Hypothesised relationships between FH, PCER, SOC and PTG.

Figure 2. Mediating effect of positive cognitive emotion regulation and sense of coherence in the relationship between family hardiness and post-traumatic growth. *p<0.05, **p<0.01, ***p<0.001. ECOG, Eastern Cooperative Oncology Group.