title: Resilience and Associated Factors among Mainland Chinese Women Newly Diagnosed with Breast Cancer.
abstract: OBJECTIVE
  Resilience is the individual's ability to bounce back from trauma. It has been studied for some time in the U.S., but few studies in China have addressed this important construct. In mainland China, relatively little is known about the resilience of patients in clinical settings, especially among patients with breast cancer. In this study, we aimed to evaluate the level of resilience and identify predictors of resilience among mainland Chinese women newly diagnosed with breast cancer.
  
  
  METHODS
  A cross-sectional descriptive study was conducted with 213 mainland Chinese women newly diagnosed with breast cancer between November 2014 and June 2015. Participants were assessed with the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ, including 3 subscales: confrontation, avoidance, and acceptance-resignation), Herth Hope Index (HHI), and demographic and disease-related information. Descriptive statistics, bivariate analyses and multiple stepwise regression were conducted to explore predictors for resilience.
  
  
  RESULTS
  The average score for CD-RISC was 60.97, ranging from 37 to 69. Resilience was positively associated with educational level, family income, time span after diagnosis, social support, confrontation, avoidance, and hope. However, resilience was negatively associated with age, body mass index (BMI), and acceptance-resignation. Multiple stepwise regression analysis indicated that hope (β = 0.343, P<0.001), educational level of junior college or above (β = 0.272, P<0.001), educational level of high school (β = 0.235, P<0.001), avoidance (β = 0.220, P<0.001), confrontation (β = 0.187, P = 0.001), and age (β = -0.108, P = 0.037) significantly affected resilience and explained 50.1% of the total variance in resilience.
  
  
  CONCLUSIONS
  Women with newly diagnosed breast cancer from mainland China demonstrated particularly low resilience level, which was predicted by hope educational level, avoidance, confrontation, and age.
authors.affiliation: School of Nursing, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Zijing
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Surgical Oncology and Breast Surgery, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Xuelian
authors.initials: X
authors.lastname: Li
authors.affiliation: School of Nursing, China Medical University, Shenyang, Liaoning, PR China.
authors.forename: Xiaohan
authors.initials: X
authors.lastname: Li
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D055500:Resilience, Psychological