Research Article| Volume 62, 102254, February 2023

Resilience among women with breast cancer surviving longer than five years: The relationship with illness perception and body image

  • Hsing-Chan Chiu
    Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Nursing, Tainan Municipal Hospital, Show Chwan Health Care System, Tainan, Taiwan
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  • Chung-Ying Lin
    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yao-Lung Kuo
    Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan

    Breast Medical Center, National Cheng Kung University Hospital, Tainan, Taiwan
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  • Wen-Li Hou
    School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan

    Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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  • Bih-Ching Shu
    Corresponding author. Institute of Allied Health Sciences, Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 70101, Taiwan.
    Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Published:December 13, 2022DOI:


      • Illness perception is a crucial predictor for better body image.
      • Better body image associate with worsen resilience.
      • Considering the personal variances during recovery process is necessary.



      This study aimed to investigate the correlations and identify the relationships between the resilience, perception of illness and body image of women with breast cancer in the 5-year-or-above survivorship.


      We used convenient sampling to recruit from an outpatient department 106 women with breast cancer. The inclusion criteria were participants aged >20 years currently in a stable condition and were able to understand the Chinese language. Those women with mental health illness were excluded. All participants completed questionnaires on the following: demographic information, revision of illness perception (IPQ-R), body image scale (BIS), Eysenck personality questionnaire (EPQ), and resilience scale (RS). We conducted the structural equation modeling (SEM) to explore the factor structure.


      SEM results showed a good fit to the data (comparative fit index = 0.97, Tucker-Lewis index = 0.94). Findings F indicated the existence of significant relationships between resilience and either illness perception or body image. Personality had a direct association with illness perception (β = 0.73, P < 0.05). Body image had an indirect effect on the relationship between resilience and illness perception (coefficient = -2.52; 95% bootstrapping CI = -31.36, −0.62).


      Results indicated that illness perception is a crucial predictor for better resilience as mediated through body image. To provide adequate information to women with breast cancer can improve their perception of breast cancer more positively. Hence, their body image and their way of coping with survival life turn better.


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