Life satisfaction moderates associations between resilience and postoperative symptom burden in oesophageal cancer: A moderated network analysis.

PURPOSE: To examine whether life satisfaction moderates associations between resilience and postoperative symptom burden among patients with oesophageal cancer.

METHODS

In a cross-sectional analysis of the "Be Resilient to Oesophageal Cancer" (BROC) programme, we studied 418 patients recruited from three hospitals in Anhui, China (August 2022-August 2023). Symptom burden was assessed with the Convalescent Symptom Assessment Scale for Oesophagectomy Patients; resilience with the 25-item Connor-Davidson Resilience Scale; and life satisfaction with the Satisfaction With Life Scale. We estimated a moderated network model to evaluate pairwise associations among symptoms and resilience nodes conditional on life satisfaction. Centrality was quantified using Expected Influence (EI). Significant moderated edges were examined with linear moderation tests and Johnson-Neyman analysis.

RESULTS

In the network, "late symptoms" were identified as the most central symptom (EI = 1.52), with the strongest association observed between "optimism" and "persistent symptoms" (r = 0.29). Moderation analyses indicated that higher life satisfaction strengthened the inverse association between strength and late symptoms (β = -0.021, SE = 0.010, P = 0.039) and weakened the positive association between strength and optimism (β = -0.013, SE = 0.005, P < 0.001). Johnson-Neyman analysis revealed similar patterns.

CONCLUSION

Life satisfaction modifies resilience-symptom associations in patients with oesophageal cancer. Screening and targeting life satisfaction may enhance the symptomatic benefits associated with resilience, informing postoperative supportive care strategies. However, the cross-sectional design precludes definitive causal inferences regarding the observed moderation effects.