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Resilience and Its Predictors Among Chinese Liver Cancer Patients Undergoing Transarterial Chemoembolization

Li, Caixia BSN; Lu, Huijuan MD; Qin, Wei BSN; Li, Xiaorong BSN; Yu, Jingxian BSN; Fang, Fang BSN

doi: 10.1097/NCC.0000000000000640

Background Although resilience has many positive effects on cancer patients, little is known about the level of resilience and its predictors in Chinese liver cancer patients undergoing transarterial chemoembolization (TACE).

Objective The aims of this study were to evaluate resilience level and identify its predictors among Chinese liver cancer patients undergoing TACE.

Methods Two hundred fifty-one patients were recruited from a tertiary hospital in Shanghai, China. According to Kumpfer's resilience framework, participants were assessed with Connor-Davidson Resilience Scale, Demographic and Disease-Related Information, Family Apgar Scale, Social Support Rating Scale, Herth Hope Index, General Self-efficacy Scale, and Simplified Coping Style Questionnaire. Multiple regression analysis was conducted to find predictors of resilience.

Results The average score for Connor-Davidson Resilience Scale was 70.33 (11.70). Multiple regression identified that educational level, time span since diagnosis, family function, social support, hope, self-efficacy, and positive coping strategies predicted higher resilience, whereas metastasis predicted lower resilience. These predictors accounted for 61.8% of the total variance in resilience.

Conclusions Resilience in liver cancer patients undergoing TACE needs to be further improved, which was positively predicted by educational level, time span since diagnosis, family function, social support, hope, self-efficacy, and positive coping strategies, but was negatively predicted by metastasis. Hope had the largest influence on resilience.

Implications for Practice Interventions aimed to improve hope are crucial to patients' resilience. Additional attention should be given to patients who had lower educational level or had metastasis. Family-centered interventions and strategies used to strengthen self-efficacy and positive coping strategies are also important in improving patients' resilience.

Author Affiliations: School of nursing (Ms C. Li and Dr Lu), Fudan University; and Departments of Nursing (Mrs Qin), Intervention Therapy (Mrs X. Li), Hepatology (Mss Yu and Fang), Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.

This work was supported by Fudan University Fuxing Nursing Research; the founded project was named “Resilience and Quality of Life in Liver Cancer Patients Undergoing TACE” (no. FNF201633).

The authors have no funding or conflicts of interest to disclose.

Correspondence: Huijuan Lu, MD, School of Nursing, Fudan University, 305 Fenglin Rd, Xuhui District, Shanghai 200032, China (

Accepted for publication June 5, 2018.

Online date: August 24, 2018

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