The Role of Family Resilience and Social Support among Cancer Patients Undergoing Chemotherapy: A Systematic Review
DOI:
https://doi.org/10.31674/mjn.2026.v17i03.026Abstract
Background: Cancer and chemotherapy impose significant physical, emotional, and psychosocial burdens on patients and their families. Family resilience, supported by belief-based coping and positive perceptions of cancer treatment, plays an essential role in maintaining stability, reducing distress, and supporting patient well-being during chemotherapy. Objective: This systematic review aimed to synthesize evidence on how belief-based family support influences family resilience in caring for cancer patients undergoing chemotherapy and to identify implications for nursing practice. Methods: A systematic review guided by the PICOS framework was conducted using Scopus, ScienceDirect, ProQuest, and Web of Science databases. Studies published between 2019 and 2024 were screened through predefined inclusion and exclusion criteria. Fourteen studies met eligibility requirements and were critically appraised using JBI, Cochrane, and CASP tools. Results: Four key themes were identified: (1) family resilience is strengthened through social support, dyadic communication, and adaptive coping mechanisms; (2) resilience-focused interventions reduce anxiety, depression, and caregiver burden; (3) psychosocial challenges during chemotherapy affect both patients and families; and (4) determinants of resilience include family cohesion, financial capacity, accessibility of treatment, and health insurance coverage. These findings underscore the importance of integrating resilience assessments and belief-based educational and coping strategies into nursing care to strengthen family support and improve patient outcomes. Conclusion: Belief-based family support plays a significant role in enhancing family resilience during chemotherapy. Incorporating resilience-building strategies into oncology nursing practice can reduce psychological distress, improve treatment adherence, and promote holistic family-centered care.
Keywords:
Belief, Cancer, Chemotherapy, Family Support, ResilienceDownloads
References
Afiyanti, Y., Gayatri, D., Besral, B., Haryani, H., & Juliastuti, D. (2021). Unmet supportive care needs survey among male partners of gynecological cancer survivors in Indonesia. Asia-Pacific Journal of Oncology Nursing, 8(6), 662-669. https://doi.org/10.4103/apjon.apjon-2113
Ahn, S.-H., & Kim, S. H. (2022). Distress, family resilience, and quality of life among family caregivers of cancer patients undergoing chemotherapy: The moderating role of family resilience. Korean Journal of Adult Nursing, 34(2), 225–232. https://doi.org/10.7475/kjan.2022.34.2.225
Ashley, A., Marsh, K., Ling, J., Lehto, R. H., Wu, H.-S., Moser, J. S., & Wittenborn, A. K. (2025). Family resilience in adult oncology: A systematic review and meta-analysis. Oncology Nursing Forum, 52(3), 228–240. https://doi.org/10.1188/25.ONF.228-240
Balci, H., & Şener, Ş. B. (2022). Meme Kanseri Cerrahisi Geçiren Kadınlarda Psikolojik Dayanıklılık [Resilience in women who underwent breast cancer surgery]. Akdeniz Tıp Dergisi, 8(3), 347-353. https://doi.org/10.53394/akd.1059556
Baltussen, J. C., de Glas, N. A., van Holstein, Y., van der Elst, M., Trompet, S., den Boogaard, A. U., ... & Portielje, J. E. (2023). Chemotherapy-related toxic effects and quality of life and physical functioning in older patients. JAMA Network Open, 6(10), e2339116-e2339116. https://doi.org/10.1001/jamanetworkopen.2023.39116
Chen, J. J., Wang, Q. L., Li, H. P., Zhang, T., Zhang, S. S., & Zhou, M. K. (2021). Family resilience, perceived social support, and individual resilience in cancer couples: analysis using the actor-partner interdependence mediation model. European Journal of Oncology Nursing, 52, 101932. https://doi.org/10.1016/j.ejon.2021.101932
Chen, X., Li, Y., Sun, H., Wang, T., Xu, X., & Li, M. (2023). Dyadic communication quality and family resilience in gynecologic cancer survivors: A study on the mediating role of perceived spousal support. Support Care Cancer, 31(1), 68. https://doi.org/10.1007/s00520-022-07492-7
Chen, X., Yan, Q., Tang, Y., Zhu, J., Zhang, W., & Zhang, J. (2024). Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study. The Breast, 75, 103735. https://doi.org/10.1016/j.breast.2024.103735
Critical Appraisal Skills Programme (CASP) (2018). CASP Checklist: CASP Qualitative Studies Checklist. https://casp-uk.net/casp-tools-checklists/qualitative-studies-checklist/
Cui, C., & Wang, L. (2024). Role of social support in the relationship between resilience and sleep quality among cancer patients. Frontiers in Psychiatry, 15, 1310118. https://doi.org/10.3389/fpsyt.2024.1310118
Cui, P., Shi, J., Li, S., Getu, M. A., Wang, R., & Chen, C. (2023). Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis. BMC Cancer, 23(1), 623. https://doi.org/10.1186/s12885-023-11101-z
Cui, P., Yang, M., Hu, H., Cheng, C., Chen, X., Shi, J., ... & Zhang, H. (2024). The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: A moderated mediation analysis of the role of psychological distress and family resilience. BMC Public Health, 24(1), 817. https://doi.org/10.1186/s12889-024-18321-3
Cumpston, M. S., McKenzie, J. E., Thomas, J., & Brennan, S. E. (2021). The use of ‘PICO for synthesis’ and methods for synthesis without meta-analysis: protocol for a survey of current practice in systematic reviews of health interventions. F1000Research, 9, 1–9. https://doi.org/10.12688/F1000RESEARCH.24469.1
Czech, O. J., Matkowski, R., Skorniak, J., & Malicka, I. (2024). Psychological and physical well-being in women diagnosed with breast cancer: A comprehensive study of anxiety, depression, sleep quality, physical activity, and sociodemographic factors. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 30, e943490-1. https://doi.org/10.12659/MSM.943490
Dionne-Odom, J. N., Azuero, A., Taylor, R. A., Wells, R. D., Hendricks, B. A., Bechthold, A. C., Reed, R. D., Harrell, E. R., Dosse, C. K., Engler, S., McKie, P., Ejem, D., Bakitas, M. A., & Rosenberg, A. R. (2021). Resilience, preparedness, and distress among family caregivers of patients with advanced cancer. Supportive Care in Cancer, 29(11), 6913–6920. https://doi.org/10.1007/s00520-021-06265-y
Gao, J., Li, J. X., Chen, W. Y., Song, J. Y., Zhou, M. K., Zhang, S. S., & Li, H. P. (2022). A randomized controlled trial of a coping-focused family resilience intervention program for breast cancer patients: Study protocol. Frontiers in Psychology, 13, 968154. https://doi.org/10.3389/fpsyg.2022.968154
Hassana, S. A. E. A. E., Khattab, A. K. A. E. R. & Moustafa, N. A. (2025). Relationship between social support, self-esteem and sense of masculinity among geriatric Patients with Prostatic Cancer. Geriatric Nursing, 61, 6-12. https://doi.org/10.1016/j.gerinurse.2024.10.079
Hermann, M., Goerling, U., Hearing, C., Mehnert-Theuerkauf, A., Hornemann, B., Hövel, P., Reinicke, S., Zingler, H., Zimmermann, T., & Ernst, J. (2024). Social support, depression, and anxiety in cancer patient-relative dyads in early survivorship: An actor-partner interdependence modeling approach. Psycho-Oncology, 33(12), e70038. https://doi.org/10.1002/pon.70038
Higgins, J. P., Green, S., & Collaboration, C. (2008). Cochrane handbook for systematic reviews of interventions. Wiley Online Library. https://onlinelibrary.wiley.com/doi/book/10.1002/9781119536604
Huang, S., Xin, L., Zheng, D., Li, H., Wang, L., Zhao, M., ... & Liu, H. (2025). Mediating and moderating roles of individual resilience, caring ability and social support: A cross-sectional study on the association between family resilience and caregiving burden among primary family caregivers of cancer patients in China. BMJ Open, 15(3), e093043. https://doi.org/10.1136/bmjopen-2024-093043
Ke, J., Lin, J., Lin, X., Chen, W. T., & Huang, F. (2023). Dyadic effects of family resilience on quality of life in patients with lung cancer and spousal caregivers: The mediating role of dyadic coping. European Journal of Oncology Nursing, 66, 102400. https://doi.org/10.1016/j.ejon.2023.102400
Kim, M., & Ahn, S. (2022). Do spouse burden of care, family resilience, and coping affect family function in gynecologic cancer in Korea?: A cross-sectional study. Korean Journal of Women Health Nursing, 28(3), 197-209. https://doi.org/10.4069/kjwhn.2022.08.03
Kwon, J. Y., Johnson, K. L., Haase, K. R., Newton, L., Fitch, M., & Sawatzky, R. (2025). Patterns of social support among older adults with cancer and associations with patient-reported outcomes: A latent class analysis. Journal of Geriatric Oncology, 16(1), 102157. https://doi.org/10.1016/j.jgo.2024.102157
Li, Y., Wang, K., Yin, Y., Li, Y., & Li, S. (2018). Relationships between family resilience, breast cancer survivors’ individual resilience, and caregiver burden: A cross-sectional study. International Journal of Nursing Studies, 88, 79-84. https://doi.org/10.1016/j.ijnurstu.2018.08.011
Liu, J., Somjaivong, B., Panpanit, L., & Zhang, L. (2025). Effect of a self-efficacy-promoting program on pain management among patients with cancer: A quasi-experimental study. Pain Management Nursing, 26(2), e194-e200. https://doi.org/10.1016/j.pmn.2024.10.009
Liu, Y., Lin, W., Pan, Y., Li, J., Lyu, J., & Li, Y. (2025). A program to enhance family resilience through improved family communication for young and middle-aged breast cancer survivors and their spouses: A feasibility study. European Journal of Oncology Nursing, 75, 102819. https://doi.org/10.1016/j.ejon.2025.102819
Lustberg, M. B., Kuderer, N. M., Desai, A., Bergerot, C., & Lyman, G. H. (2023). Mitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship. Nature Reviews Clinical Oncology, 20(8), 527-542. https://doi.org/10.1038/s41571-023-00776-9
Mao, S., Lu, H., Zhang, Y., Yu, J., Li, X., Peng, J., & Liang, Y. (2021). Evaluation of psychosocial pathways to family adaptation of chinese patients with liver cancer using the McCubbin's family resilience model. Frontiers in Psychiatry, 12, 703137. https://doi.org/10.3389/fpsyt.2021.703137
Melguizo-Garín, A., Benítez-Márquez, M. D., Hombrados-Mendieta, I., & Martos-Méndez, M. J. (2023). Importance of social support of parents of children with cancer: a multicomponent model using partial least squares-path modelling. International Journal of Environmental Research and Public Health, 20(3), 1757. https://doi.org/10.3390/ijerph20031757
Opsomer, S., Joossens, S., De Lepeleire, J., Pype, P., & Lauwerier, E. (2022). Trapped in a double cage: How patients’ partners experience the diagnosis of advanced cancer in times of the COVID-19 pandemic: An interpretative phenomenological analysis. Palliative Medicine, 36(5), 810-820. https://doi.org/10.1177/02692163221080660
Opsomer, S., Lauwerier, E., De Lepeleire, J., & Pype, P. (2022). Resilience in advanced cancer caregiving. A systematic review and meta-synthesis. Palliative Medicine, 36(1), 44-58. https://doi.org/10.1177/02692163211057749
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ, 372. https://doi.org/10.1136/bmj.n71
Pearson, A., White, H., Bath-Hextall, F., Apostolo, J., Salmond, S., & Kirkpatrick, P. (2015). A mixed-methods approach to systematic reviews. International Journal of Evidence-Based Healthcare, 13(3), 121-131. https://doi.org/10.1097/xeb.0000000000000052
Perak, K., McDonald, F. E., Conti, J., Yao, Y. S., & Skrabal Ross, X. (2024). Family adjustment and resilience after a parental cancer diagnosis. Supportive Care in Cancer, 32(7), 409. https://doi.org/10.1007/s00520-024-08608-x
Plont, M., Mejdahl, C. T., Haar, T. R., & Skovlund, P. (2023). Supporting families with breast cancer: Insights from the Danish Nurse-Led Program “The Children’s Tour” for families with parental cancer. Seminars in Oncology Nursing, 39(5), 151482. https://doi.org/10.1016/j.soncn.2023.151482
Qin, F., Wei, T., Zhao, X., He, Y., Chen, M., Luo, Z., ... & Li, G. (2024). Relationship between family resilience and dyadic coping in colorectal cancer patients and their spouses, based on the actor-partner interdependence model. European Journal of Oncology Nursing, 70, 102622. https://doi.org/https://doi.org/10.1016/j.ejon.2024.102622
Rasouli, O., Moksnes, U. K., Reinfjell, T., Hjemdal, O., & Eilertsen, M. E. B. (2022). Impact of resilience and social support on long-term grief in cancer-bereaved siblings: an exploratory study. BMC Palliative Care, 21(1), 4–11. https://doi.org/10.1186/s12904-022-00978-5
Retnaningsih, D., Nihayati, H. E., Efendi, F., & Triharini, M. (2025). Family-based belief interventions to enhance resilience in breast cancer patients undergoing chemotherapy: A qualitative study. European Journal of Oncology Nursing, 103025. https://doi.org/https://doi.org/10.1016/j.ejon.2025.103025
Ruiz-Rodríguez, I., Hombrados-Mendieta, I., Melguizo-Garín, A., & Martos-Méndez, M. J. (2022). The importance of social support, optimism and resilience on the quality of life of cancer patients. Frontiers in Psychology, 13, 833176. https://doi.org/10.3389/fpsyg.2022.833176
Shao, M., Yang, H., Du, R., Zhang, M., Zhu, J., Zhang, H., ... & Wang, T. (2023). Family resilience in cancer treatment and key influencing factors: A systematic review. European Journal of Oncology Nursing, 66, 102403. https://doi.org/10.1016/j.ejon.2023.102403
Tang, W. Z., Mangantig, E., Iskandar, Y. H. P., Cheng, S. L., Yusuf, A., & Jia, K. (2024). Prevalence and associated factors of psychological distress among patients with breast cancer: A systematic review and meta-analysis. BMJ Open, 14(9), e077067. https://doi.org/10.1136/bmjopen-2023-077067
Tao, L., Hu, X., Chen, H., Xiao, S., & Zhang, X. (2022). Factors influencing the burden on spousal caregivers of breast cancer survivors. Supportive Care in Cancer, 30(9), 7789-7799. https://doi.org/10.1007/s00520-022-07130-2
Too, W., Lelei, F., Adam, M., & Halestrap, P. (2023). Preparedness, resilience and unmet needs of informal caregivers of advanced cancer patients in a regional mission hospital in Kenya: Qualitative Study. BMC Palliative Care, 22(1), 16. https://doi.org/10.1186/s12904-022-01048-6
Ulibarri-Ochoa, A., Macía, P., Ruiz-de-Alegría, B., García-Vivar, C., & Iraurgi, I. (2024). The role of resilience and coping strategies as predictors of well-being in breast cancer patients. European Journal of Oncology Nursing, 71, 102620. https://doi.org/https://doi.org/10.1016/j.ejon.2024.102620
World Health Organization (WHO). (2025, August 14). Breast cancer. www.who.int/news-room/fact-sheets/detail/breast-cancer
Zahid, N., Zahid, W., Khalid, W., Azam, I., Ikram, M., Hassan, A., ... & Ahmad, K. (2021). Resilience and its associated factors in head and neck cancer patients in Pakistan: An analytical cross-sectional study. BMC Cancer, 21(1), 888. https://doi.org/10.1186/s12885-021-08624-8
Zamanian, H., Amini-Tehrani, M., Jalali, Z., Daryaafzoon, M., Ala, S., Tabrizian, S., & Foroozanfar, S. (2021). Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model. European Journal of Oncology Nursing, 50, 101892. https://doi.org/10.1016/j.ejon.2020.101892
Zhang, T., Yan, P., Wong, C. L., Huang, Z., Liu, li, Xiao, Y., Ma, G., Liu, Z., Xu, J., & Gu, C. (2025). Psychological resilience, dyadic coping, and dyadic adjustment in couples dealing with cervical cancer in Northwest China: A cross-sectional study. European Journal of Oncology Nursing, 74, 102785. https://doi.org/https://doi.org/10.1016/j.ejon.2025.102785
Zhang, Y., Ding, Y., Liu, C., Li, J., Wang, Q., Li, Y., & Hu, X. (2023). Relationships among perceived social support, family resilience, and caregiver burden in lung cancer families: A mediating model. Seminars in Oncology Nursing, 39(3), 151356. https://doi.org/10.1016/j.soncn.2022.151356
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