Colorectal cancer (CRC) survivors are living longer, and factors such as symptom burden and quality of life have become increasingly important. A group of researchers examined the symptom characteristics, positive psychology (benefit finding and posttraumatic growth), and quality of life (satisfaction and importance) in CRC survivors to determine if positive psychology affected the relationship between how survivors perceived their symptoms and their quality of life. The findings were published in the European Journal of Oncology Nursing.

In a cross-sectional study of 117 CRC survivors who were undergoing active treatment, data were collected by demographic questionnaire, Therapy-Related Symptom Checklist, and Quality of Life Inventory. Participants’ positive psychology level were calculated by combining the scores from the Carver Benefit Finding Scale and the Post-Traumatic Growth Inventory.

Commonly reported symptoms included peripheral neuropathy, fatigue/feeling sluggish, skin changes, sleep disturances, and weakness. Participants also reported experiencing psychological distress symptoms and moderate-to-high positive psychology and quality of life in the acute survivorship period.

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Symptom severity didn’t seem to take a big toll, but symptom frequency did.

“We observed that an increase in the number of symptoms reduced CRC survivors’ quality of life,” the researchers noted. More than one-third the CRC survivors reported psychological distress symptoms, and an increase in the number of symptoms corresponded with lower quality of life. An increase in psychological distress symptoms also decreased the survivors’ positive psychology.

Quality of life in terms of satisfaction and importance levels was reported as moderate to high by more than 80% of the CRC survivors. Higher quality of life was associated with higher levels of benefit finding, posttraumatic growth, and positive psychology.

Survivor-reported symptoms, especially anxiety, stress, and depression, need to be tracked and prioritized. Easing these symptoms can help mitigate symptom burden throughout treatment. Improved survivor awareness of influencing factors can promote positive change associated with their cancer and quality of life. Educating nurses about positive psychology could help them identify potential ways to improve positive psychology early on, too.

The cross-sectional nature of this study makes assessing for changes in the influence of positive psychology on quality of life over time difficult. Future studies could benefit from a larger sample size. The generalizability of these findings is limited due to the underrepresentation of non-Hispanic Black survivors.


Sheikh-Wu SF, Anglade D, Gattamorta K, Xiao C, Downs CA. Positive psychology mediates the relationship between symptom frequency and quality of life among colorectal cancer survivors during acute cancer survivorship. Eur J Oncol Nurs. 2022;58:102136. doi:10.1016/j.ejon.2022.102136