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Interventions for Enhancing Resilience in Breast Cancer Patients: A Realist Review

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H. Chen, X. Ding, Q. Wang, and Z. Li 1
1 School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, China

Background: Breast cancer is a growing concern worldwide. The treatment of breast cancer has
a significant impact on women’s health. Various efficacious interventions are available to enhance
resilience. However, it remains unclear how these mechanisms are triggered, or if certain contexts
favour the activation of different mechanisms.

Objective: This review aims to comprehend how the different interventions lead to changes in
outcomes of resilience in patients with breast cancer.

Methods: We followed a Realist Review methodological guideline to explore how, why, for whom, and
under what contexts the interventions on resilience seem to be effectively implemented. The following
iterative steps were involved in the review: (1) Define the research scope and develop the first iteration
of the conceptual model. (2) Search and collate the relevant evidence. (3) Appraise the literature. (4)
Extract data and synthesize the evidence. Causal assumptions were derived from articles found in
nine bibliographic databases leading to context (C)–mechanism (M)–outcome (O) configurations.

Results: In total, 65 articles were included. The target population was mostly middle-aged and old
adults with a minority of studies focused on youth. The intervention on resilience was administered Oral Presentation Abstracts
to patients with breast cancer of all stages. Key outcomes were grouped: resilience, quality of life,
treatment compliance, and satisfaction with nursing, etc. Mechanisms identified underpinning
change outcomes related to interventions (e.g., cognitive intervention) on resilience encompass
the subthemes of external factors (social support, joint action, supervision, and feedback, etc.), own
response and resources (reserve of positive psychological resources, and emotion connection, etc.),
individual changes (mood change, cognitive change, and active coping, etc.).

Conclusion: According to the study, the success of interventions for breast cancer patients depends
not only on the competence and expertise of the involved parties, but also on the quality of their
interactions. Taking into account contextual factors can increase the likelihood of successful
interventions.

Keywords: resilience, realist review, breast cancer

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Correspondence: Zheng Li, School of Nursing, Chinese Academy of Medical Sciences & Peking Union
Medical College, China
E-mail: zhengli@pumc.edu.cn

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