The Mediating and Moderating Effects of Family Resilience on the Relationship between Individual Resilience and Depression in Patients with Breast Cancer

Youqi Jiang; Bing Wu; Jiahui Chen; Ruyi Jin; Guangshan Jin; Minhao Zhang; Qin Zhou; Aiji Jiang

Youqi Jiang School of Psychology, Nanjing Normal University, Nanjing, 210000, China
Bing Wu Department of Nursing, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210000, China
Jiahui Chen Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221000, China
Ruyi Jin Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221000, China
Guangshan Jin Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221000, China
Minhao Zhang Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210000, China
Qin Zhou Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210000, China
Aiji Jiang Department of Nursing, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210000, China

Article ID: 3830

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Abstract

Objective: This study evaluated the effect of resilience on depression among patients with breast cancer from individual and familial perspectives by exploring the mediating and moderating effects of family resilience between individual resilience and depression. Methods: A questionnaire survey was conducted among 337 patients with breast cancer who were admitted to the Oncology Department of Jiangsu Province Hospital. The survey included demographic information, the Connor–Davidson Resilience Scale (CD-RISC), the Family Resilience Assessment Scale (FRAS), and the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) for Depression. The relationship among individual resilience, family resilience, and depression was analyzed using hierarchical regression and bootstrap test to assess the mediating and moderating effects of family resilience. Results: The depression scores were (13.50 ± 5.16), the individual resilience scores were (48.62 ± 17.50), and the family resilience scores were (105.98 ± 24.35). Significant differences in depression scores were observed in terms of family monthly income, average weekly exercise before diagnosis, post-diagnosis interpersonal relationship quality, and overall sleep quality in the past month (p < 0.05). Patients with lower individual resilience had significantly higher depression scores than those with higher resilience (F = 24.314, p < 0.001), and similarly, patients with lower family resilience had higher depression scores than those with higher family resilience (F = 41.660, p < 0.001). Individual resilience and family resilience were significantly negatively correlated with depression (r = −0.447 and −0.441, respectively, p < 0.001). Hierarchical regression analysis and bootstrap test showed that family resilience (β = −0.310, p < 0.001) had a partial mediating effect between individual resilience (β = −0.321, p < 0.001) and depression. The indirect effect size was −0.038, the 95% CI was (−0.056, −0.020), and the direct effect ratio was 71.43%. The interaction of family resilience and individual resilience had a moderating effect on depression (B = 0.166, p < 0.001). Family resilience negatively moderated the relationship between individual resilience and depressive symptoms and enhanced the protective effect of individual resilience against depression with increasing family resilience. Conclusion: Family resilience has mediating and moderating effects between individual resilience and depression in patients with breast cancer.

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