Factors influencing resilience in patients with advanced cancer: A cross-sectional study

Background: Advanced cancer and its treatments lead to various detrimental impacts on
patients. Resilience is an important ability to adapt to such adversity, but there is limited
information about its influencing factors, specifically in patients with advanced cancer.
Objective: This study aimed to examine the influence of social support, depression, anxiety,
hope, optimism, spiritual well-being, religious belief, and hardiness on resilience among adults
with advanced cancer.
Methods: This cross-sectional research used multi-stage sampling to select 288 participants
from a university hospital and three tertiary hospitals in northern Thailand. Data were collected
using a demographic data collection form, the Hospital Anxiety and Depression Scale (HADS),
the Thai version of the Social Support Questionnaire (SSQ), the Herth Hope Index (HHI), Life
Orientation Test-Revised (LOT-R), Buddhist Belief Questionnaire, Health-Related Hardiness
Scale (HRHS), and Connor-Davidson Resilience Scale (CD-RISC), from February 2021 to
February 2022. Data were analyzed using descriptive statistics, Pearson correlation, and
regression analysis.
Results: Depression (r = -0.47, p <0.01) and anxiety (r = -0.39, p <0.01) had a significant
negative relationship with resilience. Spiritual well-being (r = 0.74, p <0.01), hope (r = 0.67, p
<0.01), religious belief (r = 0.53, p <0.01), optimism (r = 0.40, p <0.01), social support (r = 0.33,
p <0.01), and hardiness (r = 0.21, p <0.01) had significant positive relationships with resilience.
Only hope (β = 0.29, p <0.01) and spiritual well-being (β = 0.59, p <0.01) together influenced
resilience by 64.70%.
Conclusion: Spiritual well-being and hope are crucial to resilience in patients with advanced
cancer. Nurses should provide spiritual support to strengthen patients’ ability to adapt
successfully to life with advanced cancer.