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

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.