Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Dimensions of Posttraumatic Growth in Patients With Cancer

A Mixed Method Study

Heidarzadeh, Mehdi PhD; Rassouli, Maryam PhD; Brant, Jeannine M. PhD; Mohammadi-Shahbolaghi, Farahnaz PhD; Alavi-Majd, Hamid PhD

doi: 10.1097/NCC.0000000000000537

Background: Posttraumatic growth (PTG) refers to positive outcomes after exposure to stressful events. Previous studies suggest cross-cultural differences in the nature and amount of PTG.

Objective: The aim of this study was to explore different dimensions of PTG in Iranian patients with cancer.

Methods: A mixed method study with convergent parallel design was applied to clarify and determine dimensions of PTG. Using the Posttraumatic Growth Inventory (PTGI), confirmatory factor analysis was used to quantitatively identify dimensions of PTG in 402 patients with cancer. Simultaneously, phenomenological methodology (in-depth interview with 12 patients) was used to describe and interpret the lived experiences of cancer patients in the qualitative part of the study.

Results: Five dimensions of PTGI were confirmed from the original PTGI. Qualitatively, new dimensions of PTG emerged including “inner peace and other positive personal attributes,” “finding meaning of life,” “being a role model,” and “performing health promoting behaviors.”

Conclusion: Results of the study indicated that PTG is a 5-dimensional concept with a broad range of subthemes for Iranian cancer patients and that the PTGI did not reflect all growth dimensions in Iranian cancer patients.

Implications for Practice: Awareness of PTG dimensions can enable nurses to guide their use as coping strategies and provide context for positive changes in patients to promote quality care.

Author Affiliations: School of Nursing and Midwifery, Ardabil University of Medical Sciences (Dr Heidarzadeh); and School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran (Dr Rassouli), Iran; Billings Clinic, Montana State University, Bozeman (Dr Brant); and Department of Nursing, Welfare and Rehabilitation Sciences University (Dr Mohammadi-Shahbolaghi); and School of Paramedicine, Shahid Beheshti University of Medical Sciences (Dr Alavi-Majd), Tehran, Iran.

This research was approved by the ethics committee of Shahid Beheshti University of Medical Sciences with number 1391-1-86-10-838-1 in 2013.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Maryam Rassouli, PhD, Pediatric Nursing Department, Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Vali-e Asr St, Tehran, Iran 1985717443 (

Accepted for publication June 21, 2017.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved