Resilience levels, associated factors, and their correlation with serum neurotransmitter levels in patients with gastric cancer

Table 1 Resilience, anxiety, and depression assessments

Categories	Minimum	Maximum	mean ± SD
Total resilience score	47	83	65.44 ± 6.97
Tenacity subscale	22	48	34.70 ± 5.32
Self-improvement subscale	11	29	21.13 ± 3.91
Optimism subscale	5	13	9.61 ± 1.40
SAS	35	58	46.26 ± 5.25
SDS	27	64	47.26 ± 6.25

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 2 Coping style and self-efficacy scores

Categories	Minimum	Maximum	mean ± SD
Medical coping style
Confrontation	12	20	17.45 ± 1.56
Avoidance	14	21	17.22 ± 1.47
Resignation	6	12	10.01 ± 1.08
Total self-efficacy score	16	36	27.00 ± 3.74

Table 3 Serum neurotransmitter levels, mean ± SD

Categories	DA (ng/L)	5-HT (μg/L)	NE (ng/L)
Healthy controls (n = 120)	66.94 ± 7.42	0.89 ± 0.11	40.87 ± 5.44
Gastric cancer patients (n = 141)	38.65 ± 4.98	0.62 ± 0.09	28.43 ± 3.04
t	36.614	21.807	23.229
P value	< 0.0001	< 0.0001	< 0.0001

DA: Dopamine; 5-HT: 5-hydroxytryptamine; NE: Neurotransmitter.

Table 4 Correlations between various resilience dimensions and neurotransmitter levels

Characteristic	Resilience score		Tenacity		Self-improvement		Optimism
	r	P value	r	P value	r	P value	r	P value
DA	0.439	< 0.0001	0.393	< 0.0001	0.267	0.001	-0.053	0.535
5-HT	0.525	< 0.0001	0.499	< 0.0001	0.223	< 0.0001	0.094	0.267
NE	0.576	< 0.0001	0.472	< 0.0001	0.373	< 0.0001	0.035	0.683

DA: Dopamine; 5-HT: 5-hydroxytryptamine; NE: Neurotransmitter.

Table 5 Resilience-associated socio-demographic variables (univariate assessment), mean ± SD

Characteristic	Frequency (n = 141)	Resilience score	t/F	P value
Sex			5.170	< 0.0001
Male	74	68.09 ± 6.39
Female	67	62.51 ± 6.43
Age			0.329	0.720
≤ 45	39	64.72 ± 6.99
46-59	48	65.50 ± 5.98
≥ 60	54	65.91 ± 7.82
Marital status			0.610	0.545
Single	32	65.28 ± 7.47
Married	61	64.84 ± 7.52
Divorced/widowed	48	66.31 ± 5.88
Educational level			27.71	< 0.0001
Junior high school or below	30	59.10 ± 5.11
Senior high school/technical secondary school	69	65.64 ± 6.88
Junior college/university	42	69.64 ± 4.62
Employment status			0.111	0.895
Employed	73	65.68 ± 6.61
Retired	42	65.05 ± 7.46
Unemployed	26	65.38 ± 7.39
Monthly income			47.01	< 0.0001
< 3000	34	57.26 ± 4.30
3000-5000	56	66.73 ± 5.72
5001-10000	29	67.81 ± 4.12
> 10000	22	72.25 ± 4.41
Living situation			0.970	0.382
Alone	60	65.35 ± 6.53
With spouse	50	64.66 ± 7.61
With family	31	66.87 ± 6.74
Payment mode of medical expenses			0.653	0.515
Medical insurance	89	65.15 ± 6.94
Self-funded	52	65.94 ± 7.07
Anxiety			10.56	< 0.0001
Yes	40	58.08 ± 5.61
No	101	68.36 ± 5.07
Depression			10.15	< 0.0001
Yes	37	57.84 ± 5.50
No	104	68.14 ± 5.23

Table 6 Univariate predictors (disease-related) of resilience, mean ± SD

Characteristic	Frequency	Resilience score	t/F	P value
Tumor staging			0.382	< 0.0001
I	21	73.19 ± 4.84
II	33	65.45 ± 2.85
III	71	65.20 ± 6.79
IV	16	56.31 ± 4.06
Course of disease (months)			0.041	0.125
< 10	23	62.26 ± 8.73
10-19	55	66.00 ± 6.46
20-30	36	66.19 ± 7.04
> 30	27	66.00 ± 5.76
Lymph node metastasis			0.626	0.532
Yes	77	65.10 ± 7.19
No	64	65.84 ± 6.74
Treatment modality			0.494	< 0.0001
Chemotherapy + radiotherapy	36	59.54 ± 5.36
Surgery + radiotherapy/chemotherapy	49	71.89 ± 4.01
Surgery + radiotherapy + chemotherapy	33	67.41 ± 3.94
Others	23	65.43 ± 6.72

Table 7 Multiple linear regression analysis results of resilience determinants in gastric cancer

Variable	Assignment	Regression coefficient	SE	Standardized regression coefficient	t	P value	95%CI	Collinear statistics
								Capacity	VIF
Constant		64.144	1.332		48.152	0.000	61.509-66.778
Sex	0 = female, 1 = male	2.031	0.662	0.146	3.070	0.003	0.722-3.339	0.863	1.159
Educational level	0 = junior high school or below, 1 = senior high school/technical secondary school, 2 = junior college/university	1.690	0.501	0.173	3.369	0.001	0.698-2.682	0.744	1.345
Per capita monthly income	0 ≤ 3000, 1 = 3000-5000, 2 = 5000-10000, 3 ≥ 10000	1.973	0.383	0.276	5.155	0.000	1.216-2.731	0.680	1.471
Anxiety	0 = no, 1 = yes	-2.955	0.952	-0.192	-3.104	0.002	-4.838 to -1.072	0.511	1.957
Depression	0 = no, 1 = yes	-4.316	0.869	-0.273	-4.969	0.000	-6.034 to -2.598	0.645	1.551
Tumor staging	0 = I, 1 = II, 2 = III, 3 = IV	-1.437	0.417	-0.181	-3.443	0.001	-2.262 to -0.611	0.704	1.421
Treatment modality	0 = other, 1 = chemotherapy + radiotherapy, 2 = surgery + radiotherapy/chemotherapy, 3 = surgery + radiotherapy + chemotherapy	0.132	0.344	0.019	0.385	0.701	-0.547 to -0.812	0.775	1.290

CI: Confidence interval; VIF: Variance inflation factor.