Resilience mediating the effects of cancer-related fatigue on depression, sleep, and quality of life among prostate cancer survivors.

PURPOSE: Cancer-related fatigue (CRF) is highly prevalent among prostate cancer survivors and is often accompanied by depression, poor sleep, and diminished quality of life. Resilience may help buffer these effects, but its mediating role remains insufficiently studied. This study aimed to determine whether resilience mediates the relationship between fatigue and health outcomes, including depression, sleep quality, and quality of life, in prostate cancer patients.

METHODS

A cross-sectional study was conducted with 122 prostate cancer patients recruited from two regional hospitals in southern Taiwan. Validated instruments measured fatigue (BFI), erectile function (IIEF-5), resilience (RSA), depression (CES-D), sleep quality (PSQI), and quality of life (WHOQOL-BREF, EORTC QLQ-PR25). Structural equation modeling (SEM) was applied to examine the mediating role of resilience.

RESULTS

Structural equation modeling demonstrated excellent fit (χ2/df = 1.16, GFI = .99, RMSEA = .019). Fatigue showed strong direct effects on depression (β = .69, p < .001), prostate-specific quality of life (β = -.32, p < .001), overall quality of life (β = -.25, p < .01), and sleep disturbances (β = .57, p < .001), and was negatively associated with resilience (β = -.61, p < .001). Resilience partially mediated these relationships, reducing the impact of fatigue on depression (to β = .31), prostate-specific quality of life (to β = -.09), overall quality of life (to β = .17), and sleep disturbances (to β = .37).

CONCLUSION

Resilience plays a protective role in reducing the negative impact of fatigue on psychological outcomes, sleep, and quality of life in prostate cancer patients. Incorporating resilience-building strategies into survivorship care may improve patient well-being and should be further evaluated in clinical trials.