Resilience and associated factors among Chinese patients diagnosed with oral cancer

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Abstract

Background

Resilience has been linked to psychological adaptation to many challenging life events. The present study aims to explore the level of resilience in oral cancer patients and the key factors associated with resilience, and to evaluate the relationship between resilience and anxiety.

Methods

A multiple center cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in the Stomatology Hospital of China Medical University and Department of Stomatology, Shengjing Hospital of China Medical University. Two hundred and thirty oral cancer patients replied to the questionnaires on resilience, hope, perceived social support, optimism, perceived stress and anxiety which were measured with Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10) and Zung Self-Rating Anxiety Scale (SAS), respectively. Univariate one-way ANOVA/t-test, Pearson’s r and hierarchical linear regression analysis were conducted to explore the influence factors of resilience and the relationship between resilience and anxiety.

Results

The level of resilience was 67.93 ± 12.65. Resilience was positively correlated with hope, optimism and perceived social support, and negatively correlated with perceived stress. Hierarchical linear regression analysis showed that hope (β = 0.386, P < 0.01), optimism (β = 0.190, P < 0.01) and education (β = 0.175, P < 0.01) were positively associated with resilience. The three variables in combination could explain 48.9% of the total variance in resilience. Higher level of resilience was associated less anxiety symptoms (X ² = 39.216, p = 0.000); and there was linear trend between resilience level and anxiety level among patients with oral cancer (X ² = 35.624, p = 0.000).

Conclusion

Patients with oral cancer in China had moderate level of resilience. Hope, optimism and education were positively and significantly associated with resilience, indicating that higher level of hope, optimism and education may improve resilience in oral cancer patients, which in turn may help alleviate anxiety symptoms in patients.

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Most cited references 37

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Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.

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Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test.

Michael F Scheier, Charles S. Carver, Michael W. Bridges (1994)

Research on dispositional optimism as assessed by the Life Orientation Test (Scheier & Carver, 1985) has been challenged on the grounds that effects attributed to optimism are indistinguishable from those of unmeasured third variables, most notably, neuroticism. Data from 4,309 subjects show that associations between optimism and both depression and aspects of coping remain significant even when the effects of neuroticism, as well as the effects of trait anxiety, self-mastery, and self-esteem, are statistically controlled. Thus, the Life Orientation Test does appear to possess adequate predictive and discriminant validity. Examination of the scale on somewhat different grounds, however, does suggest that future applications can benefit from its revision. Thus, we also describe a minor modification to the Life Orientation Test, along with data bearing on the revised scale's psychometric properties.

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Is Open Access

Psychometric Properties of the Chinese Version of the Perceived Stress Scale in Policewomen

Zhen Wang, Jue Chen, Jennifer E. Boyd … (2011)

Background The 10-item Perceived Stress Scale (PSS-10) is one of most widely used instruments to measure a global level of perceived stress in a range of clinical and research settings. This study was conducted to examine the psychometric properties of the Simplified Chinese version of the PSS-10 in policewomen. Methodology A total of 240 policewomen were recruited in this study. The Simplified Chinese versions of the PSS-10, the Beck Depression Inventory Revised (BDI-II), and the Beck Anxiety Inventory (BAI) were administered to all participants, and 36 of the participants were re-tested two weeks after the initial testing. Principal Findings The overall Cronbach's alpha was 0.86, and the test–retest reliability coefficient was 0.68. Exploratory Factor Analysis (EFA) yielded 2 factors with eigenvalues of 4.76 and 1.48, accounting for 62.41% of variance. Factor 1 consisted of 6 items representing “negative feelings”; whereas Factor 2 consisted of 4 items representing “positive feelings”. The item loadings ranged from 0.72 to 0.83. The Confirmatory factor analysis (CFA) indicated a very good fit of this two-factor model to this sample. The PSS-10 significantly correlated with both BDI-II and BAI, indicating an acceptable concurrent validity. Conclusions The Simplified Chinese version of the PSS-10 demonstrated adequate psychometric properties for evaluating stress levels. The results support its use among the Chinese population.

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Author and article information

Contributors

Yuqin Gao:

ORCID: http://orcid.org/0000-0002-6374-7991

957508358@qq.com

Lie Wang: liewang@mail.cmu.edu.cn

Journal

Journal ID (nlm-ta): BMC Cancer

Journal ID (iso-abbrev): BMC Cancer

Title: BMC Cancer

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2407

Publication date (Electronic): 14 May 2019

Publication date PMC-release: 14 May 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 447

Affiliations

[1 ]ISNI 0000 0000 9678 1884, GRID grid.412449.e, Department of Nursing, School of Stomatology, , China Medical University, ; Shenyang, People’s Republic of China

[2 ]ISNI 0000 0000 9678 1884, GRID grid.412449.e, Shengjing Hospital, , China Medical University, ; Shenyang, People’s Republic of China

[3 ]ISNI 0000 0000 9678 1884, GRID grid.412449.e, School of Public Health, , China Medical University, ; Shenyang, People’s Republic of China

Author information

Yuqin Gao http://orcid.org/0000-0002-6374-7991

Article

Publisher ID: 5679

DOI: 10.1186/s12885-019-5679-0

PMC ID: 6518694

PubMed ID: 31088400

SO-VID: 3e83b282-a51c-4862-b89e-31c4a43db720

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 18 February 2019

Date accepted : 3 May 2019

Funding

Funded by: project of College of Nursing, China Medical University

Award ID: 2017HL-05

Custom metadata

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: oral cancer,resilience,hope,optimism,positive psychology

Data availability:

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: oral cancer, resilience, hope, optimism, positive psychology

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