Classification and influencing factors of family resilience and posttraumatic growth in patients with spinal tumor: a cross-sectional study

Abstract

Background: Spinal tumors severely impact patients' quality of life and place a heavy psychological and emotional burden on families. Characterizing the patterns of posttraumatic growth (PTG) and family resilience is essential for developing targeted support interventions. However, existing research has primarily focused on patients' physical and psychological symptoms, with limited attention given to how families adapt and grow in the face of spinal tumors. Moreover, few studies have explored the typologies or underlying determinants of family resilience and PTG in this population. The aim of this study was to investigate the possible classifications and determinants of family resilience and PTG among individuals with spinal tumors.

Methods: We conducted a cross-sectional survey of 219 patients with malignant spinal tumors treated at the Fudan University Shanghai Cancer Center from July 2021 to July 2022. Eligible participants were aged 18 years or older, diagnosed with primary or secondary spinal tumors, and capable of completing the questionnaires in Chinese. Participants completed self-administered questionnaires with optional assistance from trained investigators, including the General Demographic Information Form, Chinese-Family Resilience Assessment Scale (FRAS-C), Posttraumatic Growth Inventory (PTGI), Family Crisis-Oriented Personal Evaluation Scales (FCOPES), and Social Support Rating Scale (SSRS). Latent profile analysis (LPA) was used to identify subgroups based on the FRAS-C and PTGI dimensions, followed by chi-square tests and multinomial logistic regression to explore differences and influencing factors.

Results: Among the 219 patients, 28.3% had primary spinal tumors, and 71.7% had secondary spinal tumors. The sample had a mean age of 55.7 (standard deviation =14.8; range, 18-84) years, with 52.5% male, and included 62 patients with primary tumors and 157 with secondary tumors. LPA categorized respondents into three groups: resistance-in-adversity (17.4%), struggling-resilience-group (45.2%), and adaptive growth group (37.4%). Significant differences were observed between these groups in terms of occupational status, housework commitment, family atmosphere, and scores on the FCOPES and SSRS scales. Regression analyses indicated that retirement [odds ratio (OR) =2.928; 95% confidence interval (CI): 1.098-7.808], family coping (OR =1.113; 95% CI: 1.063-1.165), and social support (OR =1.226; 95% CI: 1.103-1.362) were significantly associated with family resilience and PTG (P<0.05).

Conclusions: Patients with spinal tumors demonstrate distinct profiles of family resilience and PTG. Factors such as coping ability and social support play key roles in determining patient classification. These findings highlight the importance of stratified psychosocial interventions tailored to different patient subgroups to promote adaptive recovery and family adjustment.

Keywords: Family resilience; heterogeneity; latent profile analysis (LPA); posttraumatic growth (PTG); spinal tumor.