The Influence of Resilience on the Coping Strategies in Patients with Primary Brain Tumors

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.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

“…Moreover, mental health outcomes, particularly depression, are strongly associated with poorer QoL in patients with PBTs [6]. Resilience, which is the capacity of individuals to maintain stable physical and cognitive functionality despite the many challenges of cancer, may help protect against adverse mental health outcomes and improve QoL in patients with PBTs [7][8][9]. Amongst the several tools designed to assess QoL amongst patients with PBT, the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) and its brain tumor-specific module EORTC QLQ-BN20 (EORTC QLQ-Brain Neoplasms 20) have proved to be brief, reliable, and valid assessment measures [10,11].…”

Section: Introductionmentioning

confidence: 99%

Translation and validation of the Urdu version of the European organization for research and treatment of cancer core quality of life questionnaire (EORTC QLQ-C30) and brain module (QLQ-BN20) in primary brain tumor patients

Martins

et al. 2021

J Patient Rep Outcomes

Introduction This study translated and validated the Urdu version of the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire (EORTC QLQ-C30) and Brain Module (QLQ-BN20) amongst patients with primary brain tumors (PBT) in Pakistan, and assessed the correlation of QoL with resilience, depression, and anxiety. Methods Translation of the EORTC QLQ-C30 and QLQ-BN20 was performed as per EORTC guidelines. A survey comprising of Urdu translations of EORTC QLQ-C30, QLQ-BN20, Wagnild and Young Resilience Scale (RS-14) and Hospital Anxiety and Depression Scale was administered to patients with PBT at a tertiary care hospital in Pakistan. Reliability (via Cronbach alpha), content validity index (CVI) scores, construct validity, and inter-scale correlations were assessed. Results Our sample consisted of 250 patients with PBT, most commonly glioma (46.8%) and meningioma (21.2%). All patients were able to understand the Urdu translations. The Cronbach alphas for the QLQ-C30 and the QLQ-BN20 were 0.860 and 0.880, respectively. The CVI scores for clarity and relevance were high for both the EORTC QLQ-C30 (0.98 and 0.96, respectively) and the QLQ-BN20 tool (0.81 and 0.95, respectively). The global QoL domain (EORTC QLQ-C30) showed significant positive correlations with resilience (r = 0.422), and significant negative correlations with depression (r = − 0.541) and anxiety (r = − 0.502). Strong inter-scale correlations were observed between physical functioning and insomnia (r = − 0.690) and role functioning and insomnia (r = − 0.641). Conclusion Our study confirms the Urdu versions of the EORTC QLQ-C30 and QLQ-BN20 as valid clinical tools for the measurement of QoL in primary brain tumors patients within the cultural and socioeconomic context of Pakistan.

“…Mental health outcomes, particularly depression, correlate strongly with poorer QoL in patients with PBTs [8]. Resilience, which enables patients to maintain stable functionality throughout the disease course, may help protect against adverse mental health outcomes and improve QoL in patients with PBTs [9,10]. Similarly, social support is also associated with better QoL [11,12].…”

Section: Introductionmentioning

confidence: 99%

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

Martin

et al. 2021

Preprint

Introduction Despite quality of life (QoL) being recognized as an important outcome in neuro-oncology, there is a lack of research from Pakistan where sociocultural differences may influence QoL. This study aimed to measure the QoL in patients with primary brain tumors (PBTs), and assess its association with mental health outcomes, resilience, and social support. Methods A cross-sectional survey was conducted among primary brain tumor patients. QoL was measured using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Resilience was assessed by Wagnild and Young's Resilience Scale, mental health outcomes using Hospital Anxiety and Depression Scale, and social support using the Enriched Social Support Instrument. Results Our study included a total of 250 patients, with median age of 42 years (range 33-54 years). The mean global QoL of the sample was 75.73 ± 14.9. On multivariable linear regression, global QoL was inversely associated with no or low income, having hypertension (-5.77), currently using a urine catheter (-15.33), having low social support (-28.16) suffering from mild (-9.88) or symptomatic (-17.59) depression, or mild anxiety (-7.11), while resilience (0.28) demonstrated a significant positive association. Conclusion The quality of life of patients with primary brain tumors in Pakistan is a function of clinical factors such as comorbid disease and use of a urinary catheter, social factors such a family income and social support, and psychological factors such as mental illness and resilience. Our findings may be of use in the development of QoL-improving interventions within the sociocultural setting of Pakistan.