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Psychological resilience contributes to low emotional distress in cancer patients
Abstract
Purpose Although a considerable number of cancer patients suffer from emotional distress which may have an impact on their quality of life, it still remains poorly understood which psychosocial factors contribute to individual vulnerabilities to emotional distress of cancer patients. Recently, resilience has been suggested as the capacity to cope with adversities like cancer. In this study, we investigated the relationships between resilience and emotional distress in cancer patients.Methods One hundred fifty-two cancer patients who were consecutively hospitalized for their scheduled treatments at the Seoul St. Mary's Hospital were enrolled and completed the Connor-Davidson Resilience Scale and Hospital Anxiety Depression Scale to measure resilience and emotional distress. The relationships between the levels of psychological resilience and emotional distress were evaluated using univariate and multivariate logistic regression analyses.Results Psychological resilience levels were negatively associated with emotional distress after controlling for relevant covariates. The highest quartile of resilience level was associated with a 90% (adjusted odds ratio [OR] = 0.10, 95% confidence interval [CI] = 0.03-0.34, P < 0.001) reduction in the risk for emotional distress compared to the lowest quartile. Among metastatic cancer patients, resilience was also found to be a significant protective factor for emotional distress (adjusted OR = 0.14, 95% CI = 0.02-0.79, P = 0.02).Conclusion The present study suggests that psychological resilience may independently contribute to low emotional distress in cancer patients. The relationship between resilience and emotional distress was also significant in the subgroup of metastatic cancer patients. Psychosocial interventions to enhance resilience might provide useful approaches to overcome cancer-related emotional distress.
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“When facing adversity and stressful situations, people with lower resilience have a higher risk of experiencing poorer QoL, and greater distress and relational difficulties [17]”
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“[4] CAM has been mentioned in many studies among cancer survivors for mind and spirituality healing.[6-10] The societal protective factors identified among cancer survivors are perceived social support associated with positive adjustment to illness.”
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“A growing number of publications have linked resilience in patients with cancer to enhanced adaptation to symptoms of cancer, including distress and depression, and to improved quality of life [1,3].”
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“The largest number of studies (11) on the level of resilience were published in 2016.”
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“Studies of patients with different cancer types (eg, breast, lung, gastric cancer) have indicated positive associations between resilience and health-related quality of life and between resilience and lower emotional distress.(21,23) However, there is a paucity of studies evaluating the possible relevance of resilienc…”
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“Similarly, past studies have found that psychological resilience is crucial in copingwith the traumatic impacts of the cancer experience and in fostering personal growth.(18,21) Despite the importance of psychological resilience in supporting cancer survivors, literature on this is scarce.”
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The Psychological Implications of Diagnostic Delay in Colorectal Cancer Patients
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“…on resilience, defined as “healthy adaptation in the context of adversity”, has also been limited to the study of how people cope with cancer (38-40) rather than coping in the pre-diagnostic phase, although diagnostic workup of symptoms has been identified as one of the many events people…”
Galanis, P., Katsiroumpa, A., Vraka, I., Kosiara, K., Siskou, O., Konstantakopoulou, O., Katsoulas, T., Gallos, P., & Kaitelidou, D. (2023) · medRxiv · doi:10.1101/2023.02.07.23285620
“Patients with high resilience can have a stronger capacity for self-reflection and a better tolerance of negative feelings in order to achieve a better coping with anxiety, depression, and psychological distress (Min et al., 2013).”
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Burnette, C. E., Roh, S., Liddell, J. L., & Lee, Y.-S. (2019) · Journal of Ethnic & Cultural Diversity in Social Work · doi:10.1080/15313204.2019.1628680 · Cited by 7
“Though resilience – the ability of individuals, families, and communities to bounce back, recover, and transcend adversity – has been studied in a variety of other contexts, it has only more recently begun to be explored in the context of women who experience cancer (Min et al., 2013).”
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“54 While there appears to be an inverse association between distress and resilience, the direction of causality remains unclear.”
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“Resilience has also been posited to act as a protective factor for cancer patients during the pandemic [18–20], and pre-pandemic literature demonstrates that resilience is associated with lower psychological distress in cancer patients [21], even for those experiencing advanced/metastatic disease [22, 23].”
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Kanser Sürecinde Üstbilişler, Psikolojik Sağlamlık ve Nüks Korkusu
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Factors Associated with The Resilience of Breast Cancer Patients Undergoing Chemotherapy
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The pitfalls of “toughing it out”: mapping stoic attitudes in cancer patients. A scoping review
Harerimana, A., Pillay, J., & Mchunu, G. (2025) · Medicine, Health care and Philosophy · doi:10.1007/s11019-025-10293-4 · Cited by 5
“For patients with cancer, resilience is a crucial psychological attribute that enables individuals to navigate challenging situations while preserving mental and physical well-being (Min et al. 2013; Ma et al. 2024).”
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“In addition, it has been reported that highly resilient individuals tend to respond constructively despite their exposure to stressful circumstances and/or internal distress.([14,15]) Thus, patients who showed high scores for resilience might be apt to face their problem constructively.”
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“In previous research, resilience is effective for reducing psychological distress [6,7], depression [7,8], and fatigue [9] in patients.”
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Exploring Narrative and Coping Strategies of Osteosarcoma Survivors in China: A Qualitative Study
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“…disengagement, venting, self-blame for ongoing chemotherapy-related anxiety and depression [7], seeking social support, positive affectivity for post-traumatic growth [6], and emotional adaptive coping, like optimism and reflection during illness for emotional distress in the cancer journey [39].”
Esteva, M., March, S., Martín-Rabadán, M., Torres-Solera, E., & Ripoll, J. (2025) · Clinical & Translational Oncology · doi:10.1007/s12094-025-03930-0 · Cited by 3
“Another important psychological characteristic is resilience, defined as the ability to make positive adaptations when faced with adversity [9].”
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Resilience in the Care of Children with Palliative Care Needs
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“위암으로 위절제술을 시행한 환자 중 영양상태가 좋지 못한 집단에서 발생하는 불안감은 삶의 질을 저하시키는 것으로 나타나[23], 심리사회적 요인이 수 술 후 영양 상태에 큰 영향을 미치는 것으로 보고하였다[24].”
Shim, I. H., Choi, C. W., Bae, D. S., Ha, S. H., Kwon, K. A., Yoon, T. I., & Yi, O. V. (2021) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217421989144 · Cited by 3
“The result of the present study are similar to those of earlier studies reporting that psychological resilience may contribute to low emotional distress in cancer patients.(29) These findings may support psychosocial interventions to increase individual resilience as a strategy for reducing psychiatric comorbidities a…”
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“Resilience includes positive emotions, flexible thinking such as acceptance, active coping, and spirituality (4).”
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Yücel, E., Aksöz, E. O., & Aydın, B. (2021) · Mehmet Akif Ersoy Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi · doi:10.30798/makuiibf.978588 · Cited by 3
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“In particular, research has shown that psychological distress negatively relates to one's capacity for resilience (Matzka et al., 2016; Min et al., 2013; Schumacher et al., 2014; Silvera et al., 2005).”
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“On the other hand, our findings are consistent with previous research that demonstrated that higher levels of resilience, even not specifically related to the family context, were associated with lower levels of depression and anxiety in patients with cancer (Min et al., 2013).”
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Mossman, B., Perry, L. M., Gerhart, J. I., McLouth, L. E. S., Lewson, A. B., & Hoerger, M. P. (2023) · Psycho-Oncology · doi:10.1002/pon.6113 · Cited by 1
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BackgroundInfluentialPreparedness and Perceived Resilience in a Pandemic: U.S. Cancer Patients during COVID-19
Henderson, A., & Xin, H. (2022) · Universal Journal of Public Health · doi:10.13189/ujph.2022.100112 · Cited by 1
Walking the Tightrope: How and When the Paradoxical Act of Breaking Character Leads to Resilience
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Building resilience in nursing students: Coping with aggression and violence at work
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Predictors of psychological responses of grief before the loss of health
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HEALTH PSYCHOLOGY | REVIEW ARTICLE Resilience in chronic diseases: A systematic review
Cal, S. F., de Sá, L. R., Glustak, M. E., & Santiago, M. B. (2015)
Biopsychosocial Factors of Resilience in the Medically Indigent Adult Population
Puckett, K. E. (2016) · Digital Commons - ACU (Abilene Christian University)
Yundarini, N. M. C., Noorhamdani, N., & Kristianto, H. (2018) · Belitung Nursing Journal · doi:10.33546/bnj.436 · Cited by 3
“In this study the operation definition of resilience was the ability to bounce back from stressors and to continue the same social function as before (Min et al., 2013).”
BackgroundUse of The Term Resilience in Adult Cancer Patients: A Systematic Review of A Qualitative Study
Wabula, L. R., Umamity, S., & Lombonaung, E. (2020) · Health Notions · doi:10.33846/hn40402
“To address this gap, the aim of the present review was to enhance the understanding of cancer patients’ use of resilience with a focus on the following questions: (1) what are the definitions of resilience as identified by patients and researchers/study authors? and (2) what are the themes relating to attributes of re…”
BackgroundInfluentialFactors Impacting Functioning Level of Cancer Survivors in Turkey
Kaya, C., Chan, F., & Bezyak, J. (2022) · Rehabilitation Counseling Bulletin · doi:10.1177/00343552221087166
“…functioning, cognitive functioning, and social functioning (Blayer & Barr, 2007; Ciftci et al., 2013; Deimling et al., 2007; Goker et al., 2011; Min et al., 2013; Ovayolu et al., 2013; Patsou et al., 2018; Rippentrop et al., 2006; Smedema et al., 2014; Smith et al., 2011; Toptas et al., 2014;…”
BackgroundHafni, M., Wahyuni, N. S., Istiana, I., Putri, U. N., & Januar, R. A. (2023) · Psychocentrum Review · doi:10.26539/pcr.532283 · Cited by 1
SADIKOĞLU, O., & Topkaya, N. (2023) · Sosyal Politika Çalışmaları Dergisi · doi:10.21560/spcd.vi.1106275
Yun, J.-S., & Suh, E. E. (2024) · Asian Nursing Research · doi:10.1016/j.anr.2024.01.010 · Cited by 6
Boczkowska, M. A. (2024) · Roczniki Pedagogiczne · doi:10.18290/rped24161.5
Malik, N., Razzaq, S., Shabbir, A., Iqbal, N., Puri, A. M., Zia, S., & Muazzam, A. (2024) · The Asian Bulletin of Big Data Management · doi:10.62019/abbdm.v4i02.139
“Low resilience has been associated with increased odds of psychological distress in patients with cancer (Min et al., 2013) and also higher risks of sleep problems, anxiety, and depression (Lai et al., 2020).”
BackgroundEndurance and Evolution: Exploring Levels of Resilience Among Indian Breast Cancer Survivors
Alexander, A., Kuruveettissery, S., Ramesh, R. S., Srinath, B. S., Appachu, S., & Thippeswamy, R. (2024) · Illness Crisis & Loss · doi:10.1177/10541373241260157
“Studies have identi fi ed that factors such as social support, family, spirituality, physical activity, education, age, gender, and fi nance in fl uence resilience in cancer patients (Di Giacomo et al., 2016; Li et al., 2021; Matzka et al., 2016; Min et al., 2013; Wu et al., 2016; Zhang et al., 2017).”
Hyun, S. (2025) · Accounting Horizons · doi:10.2308/horizons-2023-109
Mitigating workplace loneliness, burnout, and enhancing well-being in the post-COVID hotel industry
Lee, P. C., Ge, L., & Zhang, J. Y. (2025) · Journal of Human Resources in Hospitality & Tourism · doi:10.1080/15332845.2025.2484944
“Research suggests that employees with higher resilience tend to exhibit more positive orientations, thinking, and behaviors (Cooper et al., 2013) and lower levels of psychological distress (Min et al., 2013).”
Laporte, G., Gélinas, C., Genest, C., & Aita, M. (2025) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2025.04.002
Işık, E. Ö. K., & Kayım, F. (2025) · İzlek Akademik Dergi · doi:10.53804/izlek.1696191
Ciuró, A. H., Molina, A. B. G., Benítez, J. R., Valenza-Peña, G., Santiago, M. G., López, L. L., & Valenza, M. C. (2025) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2025.2538277
“In cancer patients, higher resilience has been linked to improved psychological adjustment, better outcomes, less intense side effects, greater treatment adherence, and better overall well-being [10,11].”
Zahid, N., Zahid, W., Khalid, W., Azam, I., Ikram, M., Hassan, A., Iftikar, H., Bhamani, S. S., Jabbar, A. A., Akhtar, S., et al. (2021) · Figshare · doi:10.6084/m9.figshare.15102666
Comment apaiser les émotions du cancer
André, C. (2025) · Cerveau & Psycho · doi:10.3917/cerpsy.183.0052
Sunguroğlu, Ş., & Kumova, F. (2026) · Ayna Klinik Psikoloji Dergisi · doi:10.31682/ayna.1508771
Preston, A. K., LaPray, K., Cooper, B., Paul, S., Hammer, M. J., Levine, J. D., Conley, Y. P., Cartwright, F., Miaskowski, C., & Dunn, L. B. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-10499-z · Cited by 1
“Among the myriad of psychological outcomes observed in cancer patients is resilience, the capacity to adapt in challenging circumstances [30], which is associated with lower levels of depression and anxiety and better quality of life [31–33].”
Metadata
- Authors
- Min, J.-A., Yoon, S., Lee, C.-U., Chae, J.-H., Lee, C., Song, K.-Y., & Kim, T.-S.
- Affiliations
- The Catholic University of Korea Seoul St. Mary's Hospital (KR)
- University of Utah (US)
- Corresponding author
- Kim, Tae-Suk
- Venue
- Supportive Care in Cancer
- Published
- 2013-04-20
- Volume
- 21
- Issue
- 9
- Pages
- 2469-2476
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W2074884121
- Cited by
- 209
- References
- 62
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 10 · 2023: 19 · 2022: 21 · 2021: 26 · 2020: 18 · 2019: 17 · 2018: 21 · 2017: 9 · 2016: 18 · 2015: 17 · 2014: 5 · 2013: 4
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Keywords
- psychological resilience, emotional distress, cancer patients, metastatic cancer, psychosocial factors, anxiety, depression, quality of life, resilience interventions
- MeSH terms
- Adaptation, Psychological, Adult, Affective Symptoms, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasms, Risk Factors, Stress, Psychological, Comorbidity, Multivariate Analysis, Resilience, Psychological
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