Resilience and Social Support as Influencing Factors on the Relationship Between Psychological Distress and Quality of Life in Persons Living with Cancer. A Cross-Sectional Study at the Korle-Bu Teaching Hospital.

Abstract

Background: The psychological well-being of persons living with cancer (PLWC) could be enhanced if factors influencing the effect of psychological distress (distress) on quality of life (QoL) are well understood. Distress in PLWC is reshaped over the course of the disease, prompting the need for awareness and constant monitoring by health professionals and caregivers to identify and understand factors that mitigate the long-term implications for QoL. The influencing roles of resilience and social support on the distress-QoL relationship amongst PLWC in Ghana have not been widely explored. This study was conducted to assess the mediating role of resilience and social support in the relationship between distress and QoL. Methods: This research employed a facility-based cross-sectional analytical design. The exposure and primary outcomes were distress and QoL respectively. Resilience and social support were the mediators. A causal path analysis was adopted to assess the mediation effect of resilience and social support on the relationship between distress and QoL. All estimations were done using the 95% confidence interval. Results: The prevalence of high distress amongst respondents was 45.4% (95%CI=40.95 49.96) with overall good QoL being 52.7% (95%CI=48.12-57.16). There was no indirect effect of resilience and social support on the relationship between distress and QoL [(β(95%CI)p value = -0.0001(-0.002 to 0.002)0.877 and 0.004 (-0.01 to 0.02)0.630 respectively]. Generally, amongst persons with high distress, the adjusted odds of good QoL was 0.18 (95%CI=0.11 0.30) statistically significant. However, it significantly increased to 0.28(95%CI=0.12-0.64) when resilience was high. Conclusion: Approximately 2 out of 5 respondents experienced high distress and a little more than half experienced good QoL. There was insufficient evidence to conclude that resilience and social support mediate the relationship between distress and QoL. However, resilience was found to be an effect modifier in the relationship. This study provides evidence supporting the