Risk factors in psychological resilience of patients receiving chemotherapy for lung cancer.

[BACKGROUND] Lung cancer patients undergoing chemotherapy often experience significant psychological stress. However, the exploration of psychological resilience, a crucial coping asset, remains limited within this population. This study aimed to assess the psychological resilience of lung cancer patients undergoing chemotherapy and to identify key factors influencing their resilience, in order to guide targeted psychological interventions, improve treatment adherence, and enhance patients' quality of life.

[METHODS] A single-center observational cross-sectional design included 200 patients with stage IV lung cancer receiving chemotherapy with a regimen recommended according to the National Comprehensive Cancer Network (NCCN) guidelines. The assessment of psychological resilience was conducted using the Connor-Davidson Resilience Scale (CD-RISC). The study period spanned from January 2018 to January 2022 and involved hospitalized patients. The patients were categorized into low and high psychological resilience level (PRL) groups based on the median of CD-RISC scores. Additionally, participants completed questionnaires capturing demographic characteristics, Generalized Self-Efficacy Scale (GSES), Family Assessment Device (FAD), Ways of Coping Questionnaire (WCQ), Cancer Quality of Life Questionnaire (QLQ-C30) and Multidimensional Perceived Social Support Scale (MSPSS). Multivariate logistic regression analysis was employed to evaluate the impact of various factors on psychological resilience.

[RESULTS] CD-RISC revealed a significant positive linear correlation with GSES (R =0.605, P<0.001), FAD (R =0.229, P=0.001), QLQ-C30 (R =-0.163, P=0.02), and MSPSS (R =0.162, P=0.02). However, no significant linear correlation was observed between CD-RISC and WCQ (P=0.86). GSES, planful problem-solving, seeking social support, and objective support were identified as significant positive factors influencing psychological resilience in lung cancer patients after chemotherapy, with GSES being the strongest predictor. Additionally, FAD and QLQ-C30 scales showed marginal significance, while demographic and lifestyle factors such as gender, age, and smoking history had no significant correlation.

[CONCLUSIONS] Psychological resilience, influenced by various factors, can be enhanced in individuals with lung cancer following chemotherapy through increased self-efficacy, strategic problem-solving abilities, proactive social support-seeking skills, and objective social support. Identifying and reinforcing protective factors associated with mental resilience can promote overall adjustment and well-being among patients.