Growth in survivorship : exploring positive psychological change in survivors of haematological cancer and sexual assault

Background: Spirituality is a domain often found in posttraumatic growth (PTG), which refers to the positive psychological change experienced as the result of the struggle with trauma whereby individuals reflect on their experiences and seek to find meaning in them. Understanding the features of PTG in cancer patients can help to empower individuals to enhance their growth outcomes. However, the unique experiences of spiritual growth amongst adults surviving haematological cancer are not well understood. Purpose: This systematic review aims to synthesise the qualitative literature that explores the experiences of spirituality within the context of PTG in adults who are surviving haematological cancer. Methods: A systematic search was administered on the 7th March 2025, and articles were assessed for eligibility to conduct a focused search of the literature to answer the research question ‘What are the spiritual growth experiences of adults surviving haematological cancer?’ Five databases (PsycINFO, Medline, Embase, CINAHL, and ASSIA) were searched and a total of 16 studies were included. The studies were then quality checked by the researcher and a peer reviewer using the Critical Appraisal Skills Programme. Results: Thematic synthesis revealed four main themes to reflect the experiences of spiritual growth in adults surviving haematological cancer: 1) Adjustment; 2) Existential Growth; 3) Relationships and Connection; and 4) Sublimity. Findings highlighted how survivors used faith and spiritual practices to help them adjust to their diagnosis, grow from existential anxieties, gain support from communities and loved ones, and move closer to sublimity. Conclusions: Overall, this review presents further evidence that involving spiritual services in individuals’ care planning may provide more targeted therapeutic interventions to support survivors of haematological cancer grow from their adversity. Additionally, clinicians should assess survivors’ spiritual needs to identify opportunities to achieve personal growth outcomes. Findings from this review point to the need for more qualitative research to further our understanding of the spiritual experiences of non-religious survivors, homogenous samples of survivors from different intersecting social identities, and other domains of PTG for survivors of haematological cancer. Abstract Background: 798,000 women are raped or sexually assaulted every year in England and Wales. Due to the detrimental physical and psychological consequences experienced by survivors of this crime, it is deemed to be a major public health concern. However, there is growing evidence to suggest that many survivors of sexual assault experience posttraumatic growth (PTG), which refers to the positive psychological changes experienced as a result of the struggle with highly challenging life circumstances. Purpose: This qualitative study aimed to address the research question: What are the experiences of growth amongst women after surviving sexual assault? Methods: A purposive sample of 10 adults were recruited who identified as female, had survived sexual assault that occurred during adulthood, and had experienced positive change or growth after the assault. Online semi-structured interviews were conducted to explore broad areas of PTG and analysed from an Interpretative Phenomenological Analysis framework. Results: Four significant themes were identified: 1) barriers and challenges to PTG, 2) life’s journey and transformation, 3) interpersonal relationships and connection, and 4) empowerment and self-discovery. Conclusions: Survivors expressed how they experienced growth in a variety of areas including finding purpose and meaning, spirituality, interpersonal relationships, and personal strengths. Furthermore, participants reported several barriers and challenges to their growth journey such as trauma-related symptoms, isolation, and self-blame. Understanding the experiences of PTG could help services provide more targeted therapeutic support to improve the experiences of growth for women survivors of sexual assault.