The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: A systematic review.

Abstract Background Studies have reported mixed findings on the relationship between posttraumatic growth (PTG) and health-related quality of life (HRQOL) in cancer survivors. This review aims to give an overview of these studies and to identify potential study- and sample-level factors that could contribute to the heterogeneity of those findings on the relationship between PTG and HRQOL in cancer survivors. Methods Multiple electronic databases were systematically searched using the concepts ‘posttraumatic growth’, ‘cancer’, and ‘health-related quality of life’. Eligible studies (published until 2018) were reviewed, quality-assessed, and effect sizes were extracted and synthesized. Results Of the 37 included articles, 22 received a rating of ‘weak’, 11 ‘moderate’ and 4 ‘strong’ in study quality assessment. The overall sample comprised 7954 individuals, mean age of 55.30 years, >50% females, predominantly breast cancer, and survivors mainly within 5 years post-diagnosis. The synthesized results revealed a positive association between PTG and HRQOL (Fisher's z= 0.16) on a total scale, with significant high heterogeneity (I2=75%). Variations in HRQOL measurement and methodological inconsistency contributed to study-level differences of effect sizes. Sample-level characteristics such as geographic region, smaller sample sizes (n Limitations Studies assessing the relationship between PTG and HRQOL were heterogeneous, of weak study quality generally, and results were difficult to combine. Conclusions Most studies found a positive relationship between the factors suggesting that PTG may play a role for successful coping following cancer. However, studies of higher quality and longitudinal design are needed.