Resilience and coping styles as predictors of health outcomes in breast cancer patients: A structural equation modelling analysis

Eur J Cancer Care (Engl). 2020 Jan;29(1):e13161. doi: 10.1111/ecc.13161. Epub 2019 Sep 1.

Abstract

Introduction: Resilience has been associated with psychological adaptation to many threatening life events, but previous studies have rarely analysed the integrated relationships among demographic and disease characteristics and various health outcomes in Taiwan. This study examined the associations among demographic factors, disease characteristics, resilience, coping styles and adverse health outcomes, including anxiety and depressive symptoms and sleep disorders.

Methods: A descriptive, cross-sectional study design was used. Data from a convenience sample of 175 patients with breast cancer aged 20 years or older were collected using a self-reported questionnaire. A structural equation modelling approach was applied to examine the relationships among the variables.

Results: The results showed that greater resilience was related to fewer depressive symptoms, lower anxiety levels and better sleep quality. All three coping styles, including active coping, minimising the situation and avoidance coping, were negatively correlated with depressive symptoms, but only active coping was significantly correlated with sleep quality. Resilience had a direct effect on depressive symptoms, anxiety and sleep disorders. Furthermore, a mediating effect of resilience was observed on the relationship between marital satisfaction and depressive symptoms.

Conclusion: Resilience can strengthen breast cancer-related adaptation. Additionally, breast cancer survivors who used mainly the active and minimising coping styles tended to experience fewer depressive symptoms.

Keywords: anxiety; coping styles; depressive symptoms; resilience; sleep disorders.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Age Factors
  • Aged
  • Anxiety / epidemiology
  • Anxiety / psychology*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology*
  • Depression / epidemiology
  • Depression / psychology*
  • Educational Status
  • Female
  • Humans
  • Income
  • Latent Class Analysis
  • Marriage
  • Middle Aged
  • Neoplasm Staging
  • Prevalence
  • Resilience, Psychological*
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / psychology*
  • Taiwan / epidemiology
  • Young Adult