Differences in symptom experiences and coping strategies based on post-traumatic growth and depreciation in cancer...

To classify clusters based on post-traumatic growth (PTG) and post-traumatic depreciation (PTD) in cancer patients undergoing chemotherapy and examine between-cluster differences in symptom experiences and coping strategies.

This study used a cross-sectional design and reporting followed the STROBE checklist. Between February and August 2024, 211 cancer patients undergoing chemotherapy in Seoul hospitals completed questionnaires based on the Post-Traumatic Growth and Depreciation Inventory-Extended (PTGDI-X), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), and Coping Strategy Indicator (K-CSI). K-means cluster analysis was performed on PTG and PTD scores, with the optimal cluster number determined by the silhouette coefficient. Differences among clusters in symptom experiences and coping strategies were analyzed using one-way ANOVA with Scheffé's post hoc test.

The findings support the independent coexistence of PTG and PTD. Participants were divided into three clusters: Cluster 1 (high PTG, low PTD), Cluster 2 (moderate PTG, high PTD), and Cluster 3 (low PTG, low PTD). Problem-solving and social support seeking were highest in Cluster 1; Cluster 2 exhibited the greatest symptom experience and the highest use of avoidance. Cluster 3 showed the lowest levels of problem-solving, social support seeking, and both PTG and PTD, with relatively lower symptom experience similar to Cluster 1.

The study highlights the importance of tailored psychological assessment for cancer patients. Understanding the distinct symptom experiences and coping strategies of different PTG-PTD clusters can guide the development of individualized nursing interventions that enhance patient well-being and recovery. Findings offer practical guidance for effective psychosocial support and holistic cancer care.