Family resilience and related influencing factors in Chinese patients with malignant spinal tumors: a cross-sectional study.

Abstract

Background: Malignant spinal tumors often disrupt family dynamics, posing significant psychological and caregiving challenges. Family resilience-the ability to adapt and maintain functioning during adversity-is essential, yet understudied in this population. This study aimed to assess the level of family resilience and its associated factors among patients with malignant spinal tumors.

Methods: A cross-sectional study was conducted from July 2021 to July 2022 at two wards of Fudan University Shanghai Cancer Center. A total of 219 patients with confirmed malignant spinal tumors were recruited through convenience sampling based on specific inclusion and exclusion criteria. Data were collected using standardized instruments, including the Chinese version of the Family Resilience Assessment Scale (FRAS-C), Family Care Index Scale (APGAR), and the Social Support Rating Scale (SSRS). A pilot study validated the reliability of instruments prior to data collection. Demographic and clinical data, including neurological function and self-care ability, were also recorded. Pearson correlation, univariate analysis, and multiple linear regression were performed to identify factors associated with family resilience.

Results: Among 232 distributed questionnaires, 219 valid responses were collected (response rate: 94.4%). Of the participants, 62 had primary spinal tumors and 157 had metastatic tumors. The mean age was 56 (standard deviation =15; range, 18-84) years, and 41.6% exhibited neurological dysfunction. Additionally, 47.9% showed reduced self-care ability. The FRAS-C score of 219 patients with malignant spinal tumors was (93.79±10.36) points, among which the score of social resource utilization dimension was the lowest (8.08±1.70) points. The score of APGAR was (7.58±2.09) points, but there were still 27.9% patients with moderate to severe family dysfunction, among which the scores of growth and cooperation dimensions were the lowest which were (1.47±0.56) points and (1.48±0.58) points, respectively. The score of SSRS was (39.45±5.36) points, which was at a moderate level. Univariate analysis showed that the level of family resilience of divorced widows was significantly lower than that of married and unmarried patients. The level of resilience of single-parent families is lower than that of nuclear families and main families; The warmer the patient's home atmosphere, the higher the family resilience level. Patients with paraplegia had lower levels of family stress resistance than those with normal neurological function. Findings confirm family resilience correlates positively with family function (r=0.46, P<0.05) and social support (r=0.30, P<0.05).

Conclusions: Family resilience among patients with malignant spinal tumors was moderate, with particular deficiencies in social resource utilization. Findings underscore the importance of incorporating family-centered care and psychosocial interventions into clinical practice, especially for vulnerable subgroups. Enhancing social support and strengthening family function may help improve patient and family adaptation during illness.