Resilience and its associated factors in brain tumor patients in Karachi, Pakistan: An analytical cross‐sectional study

Abstract

Objectives This study assessed resilience in brain tumor patients at a tertiary care hospital in Pakistan (a lower middle‐income country; LMIC) and explored its relationship with patients' sociodemographic factors, clinical characteristics, social support, and mental health. Methods A cross‐sectional survey was conducted amongst adult (≥18 years) patients with brain tumor at the Aga Khan University Hospital, Pakistan. Resilience was assessed by Wagnild and Young's Resilience Scale, and patients' psychosocial characteristics by the Hospital Anxiety and Depression Scale and the Enriched Social Support Instrument. Results A total of 250 patients were included (mean age: 44 years; 68% males), with majority (97.6%) having high social support and only 4.4% and 2% having symptomatic depression and anxiety, respectively. On multivariable linear regression adjusted for covariates, lower resilience was associated with not being involved in household decision‐making (Adjusted Beta Coefficient: 4.58 [95% Confidence Interval:−7.59, −1.56]), not currently working (−2.80 [−4.61, −0.99]), undergoing multiple neurosurgical interventions such as tumor biopsies or resections (−8.64 [−13.11, −4.16]), receiving chemotherapy (−5.17 [−9.51, −0.83]) or combination adjuvant therapy (−2.91 [−5.14, −0.67]), low social support (−7.77 [−13.73, 1.81]), mild depression (−13.00 [‐17.00,‐8.99]) or symptomatic depression (−19.79 [−24.69, −14.89]), and mild anxiety (−4.24 [−7.98, −0.50]). Conclusion Our study highlights the function of familial/household role and working status in mediating resilience, and demonstrates the well‐known protective effect of resilience for mental health in brain tumor patients in Pakistan, a South‐Asian LMIC. These findings are of clinical relevance with regards to the development of culture‐specific evidence‐based resilience‐building interventions that may help patients with brain tumors to cope with the psychological distress of cancer.

Quality of Life and its associated factors amongst Patients with Brain Tumors at a Tertiary Care Hospital in Pakistan: An Analytical Cross-Sectional Study

“…In addition, all symptom components on the QLQ-BN20 were lower in our study, barring weakness of legs (mean of 18.40 ± 25.33 in our study vs. weighted mean 17.72 ± 92.99) [25]. It is possible that these ndings of an overall better QoL in our sample are a function of the higher resilience and social support, and lower depression and anxiety, which contribute towards better QoL [21]. The higher social support, in turn, is likely due to the close-knit extended family systems that are a feature of South Asian households (54% of patients in our study lived in extended families).…”

“…The higher the score on the RS-14, the higher the resilience. The Urdu version has been validated previously [21] and demonstrated excellent internal consistency in the current population as well (Cronbach's alpha of 0.903).…”

“…The median monthly household income was PKR 60000 (30000-100000)/USD 374 (187-623). The patients' sociodemographic characteristics are shown in Table 1 of the previous publication by the authors based on analysis of the same sample [24].…”

Resilience and prenatal mental health in Pakistan: a qualitative inquiry

“…The guide was developed by the research team based on a comprehensive review of the literature, and an existing conceptual framework of resilience underpinning Wagnild and Young's Resilience Scale [44,45]. This resilience scale is frequently used in studies about the resilience conducted in Pakistan, and the scale has been validated for use among Pakistani married women [53][54][55][56][57][58]. The principal investigator (PI) of the current study performed this validation while carefully taken into consideration the content and cultural biases [44] which measures the following five attributes that strengthen an individual's capacity for resilience: 1): an understanding of the meaning of life; 2) perseverance/determination; 3) existential aloneness/friendship with self; 4) equanimity and 5) selfreliance.…”

Resilience as a Factor Influencing Psychological Distress Experience in Patients with Neuro-Oncological Disease

“…In this paper, distress refers to the experience of emotional strain. Various studies have shown a correlation between distress and cancer [ 3 , 4 , 5 , 6 ]. Because approximately one-third of all patients with cancer suffer from distress that requires psycho-oncological treatment [ 7 , 8 , 9 , 10 ], it is important to investigate factors of their distress in order to be able to offer them targeted help.…”