Investigating resilience in breast cancer: a mixed-methods approach
Background: Psychological resilience has recently emerged as a topic of interest among psycho-oncology researchers and clinicians. Although this concept has been discussed with increasing frequency, the investigation and application of resilience in the cancer context is still in its infancy. Resilience has been conceptualised as a contextual phenomenon that manifests as maintenance or recovery of well-being amidst adversity, with adaptive goal- based coping processes proposed to underpin this phenomenon. This study aimed to apply a goal-based model of resilience to women with early-stage breast cancer and to determine whether adaptive goal processes of assimila- tion and accommodation underpin the maintenance or recovery of psycho- logical well-being in the six months following diagnosis. Methods: The study utilised a longitudinal mixed-methods design. Self- report questionnaires were administered at four time-points post-surgery, in conjunction with semi-structured phone interviews. To date, complete data has been collected from 14 women; the fi nal sample size will be approxi- mately 50 women. Results: Preliminary data analysis reveals that women with early-stage breast cancer hold important goals in life and that these goals are differen- tially impacted by cancer-related circumstances. Women who make adjust- ments to their goals or situation when encountering goal interference seem to be better able to continue goal pursuit and maintain a general sense of well-being and control. Longitudinal data will be further analysed with latent growth modelling and logistic regression. Cross-sectional and longi- tudinal interview data will be analysed for themes indicative of adaptive goal-based coping. Conclusions: Preliminary fi ndings indicate that a goal-based model of resil- ience has utility for understanding how resilience can be manifested in the context of breast cancer. This model has the potential to inform the psycho- social care of patients by enabling clinicians to better identify factors that may support or detract from the manifestation of resilience in the context of breast cancer diagnosis, surgery and adjuvant treatment.