Evaluation of measurement properties of post-traumatic growth questionnaires in physical health and predictors of post-traumatic growth post lung transplant

Abstract

A systematic review evaluated the psychometric properties of 23 studies examining posttraumatic growth (PTG) instruments in physical health. The methodological quality of peer-reviewed studies was assessed using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. The findings suggest that the Benefit Finding Scale, Posttraumatic Growth Inventory and Impact of Self-Concept Scale are the most psychometrically sound measures of PTG in physical health. However, further research is needed to ensure that good quality, theoretically-driven PTG instruments are developed within physical health and informed by established criteria, such as the COSMIN.

There has been growing evidence examining the existence of, and benefits from, PTG. However, limited research has been conducted with transplant patients. A mixed methods cross-sectional design explored the relationships between cognitive processing, distress, social support, resilience and PTG following lung transplant. Overall, 147 participants completed the quantitative and 12 competed the qualitative components of the study. The results showed that higher levels of deliberate rumination and social support, particularly friends, significantly predicted greater PTG. Higher levels of resilience also significantly predicted higher levels of PTG but, contrary to prediction, resilience did not mediate the relationship between deliberate rumination and social support with PTG.

Qualitative analysis provided additional support for the mechanisms underlying PTG. Deliberate rumination and social support were reflected in the themes ‘steps towards rebuilding life’, ‘looking beyond transplant’ and ‘importance of peer support’. Individuals also identified experiences related to PTG, illustrated by the subordinate themes ‘discovering a new potential’, ‘change in outlook’ and ‘appreciation for life’. This research provides a platform for further research in this area and encourages professionals to consider these constructs and ensure positive outcomes of the transplant journey. Limitations, further research and implications for clinical practice are discussed.

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