Resilience and spiritual growth of Chinese recovering from Breast Cancer: the mediating role of challenge cognitive appraisals and positive affectivity

Abstract

Background: Spiritual growth predicts well-being and longevity in cancer survivorship; while resilience has long been regarded as positive coping and post-traumatic growth. Nevertheless, little is known about how resilience is related to post-trauma spiritual growth. Method: 75 Chinese with breast cancer, attending the out-patient clinic, were invited to participate in the cross-sectional survey. They were surveyed on their trait resilience, cognitive appraisal styles, affectivity, and spiritual growth. Hierarchical regression analyses were adopted to identify the factors associated with resilience, and to explore how they relate and contribute to spiritual growth during cancer rehabilitation. Results: Controlling on age, marital status, religiosity, and treatment modality, trait resilience was positively associated with spiritual post-traumatic growth (beta = .22, p ≤ .01), challenge appraisal (beta = .27, p ≤ .01), benign appraisal (beta = .17, p ≤ .01), positive affects (beta = .53, p ≤ .01), while negative related to threat appraisal (beta = -.19, p ≤ .01), harm/ loss appraisal (beta = -.21, p ≤ .05), and negative affect (beta = -.18, p ≤ .01). Challenge appraisal (z = 2.98, p ≤ .01) and positive affects (z = 2.58, p ≤ .01) partially mediated the relationship between resilience and spiritual growth at post-trauma. Conclusions: Resilient breast cancer patients reported spiritual growth partly because they adaptively perceive the illness as a challenge and their ability to experience positive emotion amidst of trauma. The results lean support to the application of strength-based intervention models to help people with breast cancer cope.