A biopsychosocial model of resilience for breast cancer: A preliminary study in mainland China

Eur J Oncol Nurs. 2018 Oct:36:95-102. doi: 10.1016/j.ejon.2018.08.001. Epub 2018 Sep 6.

Abstract

Purpose: Patients diagnosed with breast cancer exhibited critical biopsychosocial functions following surgery or adjuvant treatment; therefore, it is important that they exhibit resilience. A Resilience Model for Breast Cancer (RM-BC) was developed using Chinese breast cancer patients to increase our understanding of how resilience outcomes are positively and negatively affected by protective and risk factors, respectively.

Methods: Chinese women with breast cancer completed the questionnaires within 1 week of beginning treatment. Exploratory Structural Equation Modeling was used to evaluate the RM-BC using a sample size of 342 patients.

Results: RM-BC suggested satisfactory goodness-of-fit indices and 67 percents of variance for resilience was explained. The Fit Indices for the measurement model were as follows: CFI = 0.909, GFI = 0.911, IFI = 0.897, NFI = 0.922, PNFI = 0.896, PCFI = 0.884, and RMSEA = 0.031. Three risk factors - emotional distress, physical distress, and intrusive thoughts - and four protective factors - self-efficacy, social support, courage-related strategy, and hope - were recognized.

Conclusion: The resilience model allows for a better understanding of Chinese breast cancer patients' resilience integration while undergoing treatment and provides an effective structure for the development of resilience-focused interventions that are grounded in their experiences. A randomized trial has provided evidences of feasibility in Chinese women with breast cancer and the resilience model could be used as a useful framework for more resilience intervention in the future.

Keywords: Biopsychosocial adjustment; Breast cancer; Mainland China; Oncology; RM-BC; Resilience model; SEM.

MeSH terms

  • Adult
  • Asian People / psychology*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / therapy
  • China
  • Emotions
  • Female
  • Humans
  • Latent Class Analysis
  • Middle Aged
  • Resilience, Psychological*
  • Risk Factors
  • Self Efficacy
  • Social Support
  • Stress, Psychological
  • Surveys and Questionnaires