Relationships between family resilience, breast cancer survivors' individual resilience, and caregiver burden: A cross-sectional study

Background: Caregivers of breast cancer survivors experience various types of burden, which in turn is linked to patients' physical and psychological status. Family resilience might be able to decrease caregiver burden and facilitate survivors' individual resilience, and individual resilience might be related to caregiver burden. Nevertheless, these relationships have not yet been confirmed. Objective: To determine the relationships between family resilience, breast cancer survivors' resilience, and principal caregivers' caregiver burden, as well as determine whether breast cancer survivors' individual resilience plays a mediating role in the relationship between family resilience and caregiver burden. Design: Cross-sectional study design. Setting: The comprehensive cancer center of a public hospital in Shandong Province, China. Participants: The sample comprised 108 dyads of early-stage breast cancer survivors and their principal care-givers. Methods: The principal caregivers completed the Shortened Chinese Version of the Family Resilience Assessment Scale and the Chinese Version of the Zarit Caregiver Burden Interview, while the breast cancer survivors completed the 10-item Chinese version of the Connor-Davidson Resilience Scale and provided their sociodemographic information. The mediating effect of individual resilience was estimated using the bootstrap method via IBM SPSS Amos 21.0. Results: Caregiver burden was significantly negatively associated with both family resilience and breast cancer survivors' individual resilience (both p<.01). Furthermore, individual resilience mediated the relationship between family resilience and caregiver burden (b = -0.052; 95% confidence interval: -.412, -.036). Conclusions: The findings suggest that both family resilience and breast cancer survivors' individual resilience may ease caregiver burden among the principal caregivers of breast cancer survivors, and family resilience tends to promote the survivors' individual resilience. Therefore, family resilience and survivors' individual resilience should be enhanced for breast cancer survivors and their family to ease the principal caregivers' caregiver burden.