Family Mutuality Enhances the Family Resilience of CRC Patients through Positive Family Functioning

Abstract

Aims: To elucidate the influencing factors of family resilience of postoperative colorectal cancer (CRC) patients, and how family resilience is affected by family function and mutuality. Methods: In this cross-sectional study, we investigated 216 postoperative CRC patients from two public hospitals. We started by studying the sociodemographic and disease-related factors impacting family resilience of CRC patient families through t-tests, one-way ANOVA, and Post Hoc Multiple Comparisons. To understand how family resilience could be affected from the family level, given the critical role of the copying capacity of family in the outcomes of postoperative CRC patients, we further investigated three key aspects of a family, i.e., family resilience, family function, and family mutuality using the Family Resilience Questionnaire (FaREQ), the Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Scale, and the Mutuality Scale (MS). Then, based on all these results, we examined the interaction between family resilience, family function, and mutuality through Pearson correlations and the SPSS PROCESS macro. Results: Six factors were identified to be associated with family resilience among families of postoperative CRC patients, including postoperative duration(F=3.684, p=0.013), education level (F=7.609, p< 0.001), marital status (F=2.822, p=0.040), working status (F=3.807, p=0.024), family income (F=9.487, p<0.001), and stoma status (t=-2.991, p=0.003). We found that family resilience was positively correlated with both family mutuality (r=0.170~0.473, p<0.05) and family function (r=0.135~0.451, p<0.05). Furthermore, we found that a healthy family mutuality could enhance family resilience, and the effectiveness of this enhancement was affected by the status of family function. Conclusions: In addition to sociodemographic and disease-related factors, this work studied the influence factors of family resilience of CRC patient families from a unique perspective, by systematically investigating the interaction between family resilience, family function, and family mutuality. Our results suggested that (1) family mutuality and family function were protective factors for family resilience; (2) Family function played a crucial role in mediating the positive effects of mutuality on family resilience. Based on our results, we suggest that healthcare professionals should assess family resilience actively from not only the sociodemographic and disease levels, but also from a more comprehensive family level, to develop effective intervention strategies to enhance the coping and adaptive capacities of families of CRC patients during the postoperative cancer management.