Exploring psychological resilience and demoralisation in prostate cancer survivors

Abstract

Objective This study aimed to investigate psychological resilience and demoralisation and their predictors and mediators in prostate cancer survivors (PCSs). Methods A cross‐sectional research design was used. PCSs (N = 122; mean time since diagnosis = 54.79 months, range in 13 years and 2 months) were recruited using convenience sampling at the outpatient department of a hospital in Taiwan. Data collection was conducted using self‐report structured questionnaires, including one for demographic and disease characteristics, the Expanded Prostate Cancer Index Composite, Cancer Survivors' Self‐Efficacy Scale, Connor–Davidson Resilience Scale and the Demoralisation Scale. Results In PCSs, a lower most‐recent level of prostate‐specific antigen and higher cancer‐specific self‐efficacy were associated with better psychological resilience. Further, fewer hormonal, bowel and urinary symptoms and bother; higher cancer‐specific self‐efficacy; and better psychological resilience were associated with less demoralisation. Cancer‐specific self‐efficacy was a mediator for the relationship between urinary symptoms and bother and demoralisation, while psychological resilience mediated the relationship between cancer‐specific self‐efficacy and demoralisation. Conclusions The results reveal that cancer‐specific self‐efficacy is a protective factor against demoralisation and increases psychological resilience in PCSs. Better psychological resilience and fewer physical symptoms and bother are associated with less demoralisation in PCSs.

Demoralization in cancer survivors: an updated systematic review and meta‐analysis for quantitative studies

“…Elder age (coefficient = 0.4033, P < 0.001), 25,27–30,34,35 and a higher female ratio (coefficient = 41.49, P < 0.001) 25,27–32,34,35 were correlated with increased demoralization score (see Appendix Figs S4 and S5). Higher married or living together ratio (coefficient = 29.62, P < 0.001) was also associated with higher demoralization score 25,28,30,32,34,35 . However, when the female ratio was added as a controlled covariate, the coefficient of marital status reduced (coefficient = 20.18, P < 0.001) (See Appendix Figs S6 and S7).…”

“…For the quantitative results of the Demoralization Scale with 24 items, meta-analysis was performed. [24][25][26][27][28][29][30][31][32][33][34][35] Other articles with different forms of Demoralization Scale (DS-II, DS-6) were reviewed but were not included in the meta-analysis. [36][37][38][39][40] Results were calculated using Comprehensive Meta-Analysis software (version 3, Biostat, Englewood, NJ, United States).…”

“…For the quantitative results of the Demoralization Scale with 24 items, meta‐analysis was performed 24–35 . Other articles with different forms of Demoralization Scale (DS‐II, DS‐6) were reviewed but were not included in the meta‐analysis 36–40 .…”

“…Meta-regression was performed to see if age, gender, marital status, or depression level could influence the demoralization level. Elder age (coefficient = 0.4033, P < 0.001), 25,[27][28][29][30]34,35 and a higher female ratio (coefficient = 41.49, P < 0.001) 25,[27][28][29][30][31][32]34,35 were correlated with increased demoralization score (see Appendix Figs S4 and S5). Higher married or living together ratio (coefficient = 29.62, P < 0.001) was also associated with higher demoralization score.…”

“…Higher married or living together ratio (coefficient = 29.62, P < 0.001) was also associated with higher demoralization score. 25,28,30,32,34,35 However, when the female ratio was added as a controlled covariate, the coefficient of marital status reduced (coefficient = 20.18, P < 0.001) (See Appendix Figs S6 and S7). The patient health questionnaire (PHQ)-9 scale is designed for assessment of depressive symptoms severity, with 0-4 indicating no depressive symptoms, 5-9 mild depressive symptoms, 10-14 moderate depressive symptoms, 15-19 moderately severe depressive symptoms, and 20-27 severe depressive symptoms.…”