3.Discussion
PTG theory suggests that traumatic events such as cancer cause individuals to change their original worldview and cognitive-behavioral patterns, to cope with traumatic events while experiencing pain, and to actively seek solutions to problems(Tedeschi R G & Calhoun L G 1996). The post-traumatic growth experiences of thyroid cancer patients in this study are largely consistent with PTG theory.
3.1 Seek effective responses to promote positive transformation of negative emotions
It has been suggested that negative emotions, such as anxiety, seriously affect the prognosis of patients(Sharpe L et al.2018). With the outbreak of the new crown epidemic, a series of adverse reactions occur in individuals and society, and the physical and mental health and well-being of individuals are seriously threatened(Minihan E et al.2020).The results of this interview showed that thyroid cancer patients usually experience negative emotions such as shock and sadness. And, there was a positive trend of shifting the negative emotions of thyroid cancer patients during the treatment.In Fujimoto’s study of PTG in cancer patients, it was concluded that a future-oriented positive coping style plays a key role in the patient’s reintegration into the social environment and reestablishment of social functioning as an extremely valuable spiritual resource(Fujimoto T & Okamura H 2021).Several patients in this study showed a vision of a new life. The hope that patients perceive in the pain of trauma contributes to post-traumatic growth, and the expectation of new possibilities is an important part of motivating patients to cope positively.Health care professionals should conduct a comprehensive assessment of the patient’s coping style and apply individualized coping strategies to shift the patient’s perspective on grief. Patients may be guided to engage in patient-to-patient communication or to vent negative emotions through disclosure, etc.
3.2 Strengthened support systems to help patients through difficult times together.
As an inert cancer, thyroid cancer has a high survival rate, a low recurrence and metastasis rate. However, some patients in this interview still expressed traumatic stress reactions such as fear and even collapsed after diagnosis. Our research found that patients with low knowledge of thyroid cancer exhibited more severe physical and psychological stress, and that psychological stress decreased with increasing knowledge, which is consistent with Morton’s findings(Morton R P 2003). Currently, health education provided by health care professionals is mostly focused during hospitalization and follow-up. Therefore, it is necessary to provide early knowledge support at the time of patient screening and diagnosis.
It has been shown that social support system has a positive contribution to PTG in cancer patients(Ruf M et al.2009).It has been argued that patients with a harmonious and stable family structure have a stronger desire to overcome the disease(Barnett M E et al 2014).This interview found that in addition to support from within the family, social support from friends, co-workers, and health care professionals inspired patients.Therefore, medical and nursing staff can start with the different family characteristics of the patient and focus on strengthening the internal support system of the patient’s family, taking into account the social support of the patient.
3.3Guiding patients to perceive PTG and promoting good psychological adjustment
The occurrence of PTG in thyroid cancer patients depends on factors such as personal traits, cognitive processing, and mental strength. Good personality traits and personal past experiences are favorable conditions for traumatized individuals to achieve growth. Therefore, under the dual trauma of the epidemic and the disease, healthcare professionals should provide positive guidance to patients, tap into their inner resources, and create conditions for their growth.
Cognitive processing is a key part of the patient’s acceptance of trauma toward growth, the patient’s ability to make efforts to regulate pain is extremely important to the process of PTG production, and whether or not cognitive processing is perfect influences the occurrence of PTG(Baník G & Gajdošová B 2014), while disclosure plays a key role in cognitive processing.Therefore, health care workers should patiently guide patients in cognitive processing, listen to their stories, and respond positively with empathy, which will help strengthen patients’ perception of personal value, stimulate their inner potential, and make them brave to fight against trauma.
In terms of spiritual perception, this study did not conclude that growth in religious beliefs in thyroid cancer patients.The reason for this analysis may be related to the differences in cultural beliefs between China and the West. The increase in empathy is seen as an increase in the power of religious beliefs in the West, while in China it is attributed to Confucianism.Therefore, when guiding patients to perceive PTG, health care professionals should fully consider the differences between Chinese and Western cultures, respect the cultural backgrounds of different countries.