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Roles of Reexamination of Core Beliefs and Rumination in Posttraumatic Growth Among Parents of Children With Cancer

Comparisons With Parents of Children With Chronic Disease

Irie, Wataru PhD, RN; Shiwaku, Hitoshi PhD, RN; Taku, Kanako PhD; Suzuki, Yuko MSN, RN; Inoue, Yukiko PhD, RN

doi: 10.1097/NCC.0000000000000731
Article: PDF Only

Background Studies have indicated that the impact of a traumatic experience can be negative and can provide the opportunity to experience psychological growth, known as posttraumatic growth (PTG).

Objective To evaluate the role of cognitive processing in PTG among parents of childhood cancer survivors (CCSs) based on the PTG theoretical model. We compared the model between parents of SCC and parents of children with chronic disease (CCDs) to determine how the role of cognitive processing in PTG is different depending on the children’s illness.

Methods Final sample consisted of 78 parents of CCSs and 44 parents of CCDs. The survey included standardized measurements assessing reexamination of core beliefs, intrusive and deliberate rumination, posttraumatic stress symptoms, and PTG. The hypothetical relationships among the variables were tested by covariance structure analysis.

Results Posttraumatic growth among parents of CCSs had significantly strong association with reexamination of core beliefs, but not with deliberate rumination. Reexamination of core beliefs was significantly more likely to foster PTG among parents of CCSs, whereas deliberate rumination was significantly more likely to be associated with PTG among parents of CCDs.

Conclusions For parents of CCSs, reexamination of core beliefs had a greater impact on PTG than deliberate rumination. Our results suggest that support should focus on the process of reexamining core beliefs in facilitating PTG among parents of CCSs.

Implications for Practice Nurses should provide parents of CCSs with reassurance regarding their experiences of the reexamination of core beliefs, which will likely lead to PTG.

Author Affiliations: Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan (Drs Irie, Shiwaku, and Inoue and Ms Suzuki); Department of Psychology, Oakland University, Rochester, Michigan (Dr Taku); and Sendai Akamon College, Sendai, Miyagi, Japan (Dr Inoue).

Correspondence: Wataru Irie, PhD, RN, Postgraduate Course of Health Sciences, Division of Family Nursing, Department of Child Health Nursing, Tohoku University Graduate School of Medicine, 2-1, Seiryou-machi, Aoba-ku, Sendai, Miyagi, 980-8575 Japan (

This work was supported by JSPS KAKENHI grant JP15H06561.

The authors have no conflicts of interest to declare.

Accepted for publication March 27, 2019.

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