Impact of Posttraumatic stress disorder (PTSD) on Health-related quality of life of cancer patients: Role of experiential avoidance and psychological resilience

Background: Cancer is a serious chronic health condition known to potentially trigger negative psychological consequences including posttraumatic stress disorders symptoms and poor health-related quality of life. This study aims to examine the impact of posttraumatic stress disorder symptoms on health-related quality of life; and to explore the role of experiential avoidance and resilience as potential mechanisms of the association among cancer patients. Methods: Data were obtained from 251 cancer patients (153 (61%) females, M age = 43.22; SD = 10.93) conveniently selected from University of Nigeria Teaching Hospital, Ituku-Ozala, Enugu State, Nigeria. Participants were diagnosed with either colon cancer 19 (7.6%), prostate cancer 50 (19.9%), liver cancer 20 (7.9%), gastric cancer 21 (8.4%), breast cancer 61 (24.3%), or other kinds of cancer 80 (31.9%). They completed relevant self-report measures such as the PTSD Checklist for DSM 5 (PCL), Acceptance and Action Questionnaire 11 (AAQ), Resilience Scale (RS) and Functional Assessment of Cancer Therapy-General (FACT-G). Descriptive statistics, Pearsons’s correlation and Hayes PROCESS macro for SPSS were used for analysis. Results: Results showed that posttraumatic stress disorders symptom was negatively associated with health-related quality of life, and this link was moderated by experiential avoidance such that high posttraumatic stress disorders symptom was associated with poor health-related quality of life among cancer patients with average and high, but not among those with low levels of experiential avoidance. Moreover, the association between posttraumatic stress disorder symptoms and health-related quality of life was mediated by psychological resilience. Conclusion: These findings have revealed that experiential avoidance is a pathway through which posttraumatic stress disorder symptoms lead to poor health-related quality of life among cancer patients; and that psychological resilience may protect patients from the negative impact of posttraumatic stress disorder symptoms on health-related quality of life. Therefore, interventions such as acceptance-based behavioral approach might be very useful in reducing experiential avoidance and posttraumatic stress disorder symptoms severity. In addition, resilience enhancement therapies could be very critical in reducing distress and promoting psychological resilience and quality of life of cancer patients.