Journal of Clinical Nursing

Family Resilience and Quality of Life Among Chinese Patients With Acute Leukaemia: A Moderated Mediation Model of Cognitive Appraisal and Coping Style

ABSTRACT

Aims and Objectives

To identify whether cognitive appraisal and coping style have moderating and mediating effects on the relationship between family resilience and quality of life (QoL) in patients with acute leukaemia (AL).

Background

AL is a clonal and aggressive haematological malignancy that requires long-term and continuous therapy, which may negatively influence QoL. Family resilience can be used as a psychosocial resource that may enhance patients' coping processes and QoL.

Design

This cross-sectional descriptive study was conducted among hospitalised patients with AL from June 2022 to June 2023.

Methods

A cross-sectional study was performed following the STROBE Statement. Convenience sampling was used in the present study, and 286 patients were recruited from five tertiary Grade A hospitals in Xi'an, China. The questionnaires included the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu), the Cognitive Appraisal of Health Scale (CAHS), the Trait Coping Style Questionnaire (TCSQ) and the Family Hardiness Index (FHI). We used SPSS 26.0 and Hayes' PROCESS macro for data analyses and path coefficients.

Results

The QoL of patients with AL was significantly positively correlated with family resilience and positive coping, and negatively correlated with cognitive appraisal. Cognitive appraisal partially mediated the relationship between family resilience and QoL. Positive coping moderated the relationships between family resilience and cognitive appraisal, and between cognitive appraisal and QoL.

Conclusions

The results revealed that the association between family resilience and QoL was partially mediated by cognitive appraisal and that positive coping moderated this relationship. These findings are meaningful for early interventions that reduce the risk of psychosocial distress and improve QoL in this population.

Relevance to Clinical Practice

Nurses should focus on the cognitive appraisal and coping style of AL patients and provide family support and respect to improve their QoL.

Patient or Public Contribution

This cross-sectional descriptive study was conducted on patients with AL undergoing clinical chemotherapy in Chinese medical facilities.