DOI: https://doi.org/10.14710/dmj.v15i5.55523

THE ROLE OF FAMILY FUNCTIONING AND TREATMENT SELF-EFFICACY IN RESILIENCE AMONG WOMEN WITH BREAST CANCER

Maryati Rizka Sari  -  Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
Nida Ul Hasanat orcid  -  Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
*Rizki Nur Pratama orcid  -  Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
Open Access Copyright 2026 Maryati Rizka Sari, Nida Ul Hasanat, Nida Ul Hasanat, Rizki Nur Pratama, Rizki Nur Pratama
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Abstract

Background: Resilience plays a critical role in enabling women with breast cancer to adapt to diagnosis and treatment-related challenges. This study examined the roles of family functioning and treatment-related self-efficacy in predicting resilience among women with stage II–III breast cancer in Yogyakarta and Banda Aceh using a cross-sectional quantitative design (N = 81). Data were collected using the Connor–Davidson Resilience Scale (CD-RISC), the General Functioning subscale of the McMaster Family Assessment Device (FAD), and the Symptoms Management Self-Efficacy Scale for Breast Cancer (SMSES-BC) and analyzed through multiple regression. The findings indicated that although family functioning and treatment-related self-efficacy jointly contributed to resilience, only family functioning emerged as a significant independent predictor (β = 0.398, p = 0.002). In contrast, treatment-related self-efficacy did not show a significant independent effect (β = 0.133, p = 0.282). Together, the variables explained 23.8% of the variance in resilience. These findings identify family functioning as the most salient psychosocial factor in fostering resilience among women undergoing breast cancer treatment and emphasize the need to integrate family-centered approaches, such as communication training and caregiver education, into psychosocial support programs. Future longitudinal and mixed-methods research is recommended to examine additional potential mediating or moderating mechanisms through which treatment-related self-efficacy influences resilience.

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Keywords: family functioning, self-efficacy in treatment, resilience, breast cancer
Funding: Ministry of Health of the Republic of Indonesia (Kementerian Kesehatan Republik Indonesia) under contract Scholarship Program

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  1. Agustina, R., Fetzer, S. J., Lai, W. S., Konlan, K. D., Romadhon, P. Z., & Lin, M. F. (2024). ABCDE assessment for palliative care truth-telling dilemmas: a case study. International journal of palliative nursing, 30(8), 444-450. https://doi.org/10.12968/ijpn.2024.30.8.444
  2. Aiken, L. R. (1985). Three coefficients for analyzing the reliability and validity of ratings. Educational and Psychological Measurement, 45(1), 131–142. https://doi.org/10.1177/0013164485451012
  3. Alexander, A., Kaluve, R., Prabhu, J. S., Korlimarla, A., Srinath, B. S., Manjunath, S., Patil, S., Gopinath, K. S., & Sridhar, T. S. (2019). The impact of breast cancer on the patient and the family in an Indian perspective. Indian Journal of Palliative Care, 25(1), 66–72. https://doi.org/10.4103/IJPC.IJPC_158_18
  4. Antari, N. K. W., Jayanti, D. M. A. D., & Sanjiwani, A. A. S. (2023). Hubungan resiliensi dengan tingkat kecemasan pasien kanker payudara yang menjalani kemoterapi. Jurnal Keperawatan Jiwa, 11(2), 293–304
  5. Aspinwall, L. G., & MacNamara, A. (2005). Taking positive changes seriously: Toward a positive psychology of cancer survivorship and resilience. Cancer, 104(11 Suppl.), 2549–2556. https://doi.org/10.1002/cncr.21244
  6. Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman
  7. Baraqbah, A., & Hatta, M. I. (2017). Studi deskriptif mengenai resiliensi pada pasien kanker serviks. Prosiding Psikologi, 286–292
  8. Chirico, A., Serpentini, S., Merluzzi, T., Mallia, L., Del Bianco, P., Martino, R., Trentin, L., Bucci, E., De Laurentiis, M., Capovilla, E., Lucidi, F., Botti, G., & Giordano, A. (2017). Self-efficacy for coping moderates the effects of distress on quality of life in palliative cancer care. Anticancer Research, 37(4), 1609–1615. https://doi.org/10.21873/anticanres.11491
  9. Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113
  10. Desweni, E., Harahap, W. A., & Afriwardi. (2021). Pemeriksaan payudara sendiri dengan stadium kanker payudara. Journal of Telenursing, 3(2), 629–635
  11. Duran, S., Avci, D., & Esim, F. (2020). Association between spiritual well-being and resilience among Turkish patients. Journal of Religion and Health, 59(6), 3097–3109. https://doi.org/10.1007/s10943-020-01000-z
  12. Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9(2), 171–180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x
  13. Gebremedhin, T. K., Cherie, A., Tolera, B. D., Atinafu, B. T., & Demelew, T. M. (2021). Prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy treatment in Ethiopia: A cross-sectional study. Heliyon, 7(6), e07362. https://doi.org/10.1016/j.heliyon.2021.e07362
  14. Global Burden of Disease Cancer Collaboration. (2020). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
  15. He, Y., Liu, X., Lin, T., Guo, X., & Chen, J. (2024). The mediating role of perceived stress in the association between family resilience and psychological distress among gynecological cancer patients: a cross-sectional study. BMC psychiatry, 24(1), 622. https://doi.org/10.1186/s12888-024-06060-z
  16. Hill, J., Holcombe, C., Clark, L., Boothby, M. R. K., Hincks, A., Fisher, J., Tufail, S., & Salmon, P. (2010). Predictors of onset of depression and anxiety after diagnosis of breast cancer. Psychological Medicine, 41(7), 1429–1436. https://doi.org/10.1017/S0033291710001868
  17. Jiang, L., Wang, M., Chen, Y., & Liu, Q. (2023). Mediating role of resilience between family functioning and quality of life in patients with advanced cancer. Journal of Psychosocial Oncology, 1–15. https://doi.org/10.1080/07347332.2023.2231431
  18. Karademas, E. C., Simos, P., Pat-Horenczyk, R., et al. (2023). The interplay between trait resilience and coping self-efficacy in patients with breast cancer. Journal of Clinical Psychology in Medical Settings, 30(1), 119–128. https://doi.org/10.1007/s10880-022-09872-x
  19. Khatimah, K. (2020). Peran moderasi oleh family hardiness dan mediasi oleh family functioning [Tesis, Universitas Indonesia]
  20. Kirana, L. A. (2016). Dukungan sosial dan resiliensi pada pasien kanker payudara. Psikoborneo: Jurnal Ilmiah Psikologi, 4(4), 522–529
  21. Konradsen, H., Dieperink, K. B., Lauridsen, J., Sorknaes, A. D., & Ostergaard, B. (2018). Validity and reliability of family functioning questionnaires. Scandinavian Journal of Caring Sciences, 32(4), 1447–1457. https://doi.org/10.1111/scs.12591
  22. Kukihara, H., Yamawaki, N., Ando, M., Nishio, M., Kimura, H., & Tamura, Y. (2020). The mediating effect of resilience between family functioning and mental well-being. Health and Quality of Life Outcomes, 18(1), 1–8. https://doi.org/10.1186/s12955-020-01486-x
  23. Liang, S. Y., Wu, W. W., Kuo, C. Y., & Lu, Y. Y. (2015). Development of the symptom-management self-efficacy scale for breast cancer. Asian Nursing Research, 9(4), 312–317. https://doi.org/10.1016/j.anr.2015.09.001
  24. Martino, M. L., Gargiulo, A., Lemmo, D., & Margherita, G. (2019). Cancer blog narratives of women with breast cancer. The Qualitative Report, 24(1), 158–173
  25. Miller, I. W., Epstein, N. B., Bishop, D. S., & Keitner, G. I. (1985). The McMaster Family Assessment Device: Reliability and validity. Journal of Marital and Family Therapy, 11(4), 345–356. http://dx.doi.org/10.1111/j.1752-0606.1985.tb00028.x
  26. Miller, I. W., Ryan, C. E., Keitner, G. I., Bishop, D. S., & Epstein, N. B. (2000). The McMaster approach to families. Journal of Family Therapy, 22(2), 168–189. https://doi.org/10.1111/1467-6427.00145
  27. Ministry of Health of the Republic of Indonesia. (2025). Call for paper informasi kesehatan nasional pencegahan, tatalaksana dan registrasi kanker payudara angkatan 1. https://lms.kemkes.go.id/courses/38b962c5-5d5b-4df6-80fd-fe1965cc5c1d
  28. Mufidah, A. C. (2017). Hubungan dukungan sosial terhadap resiliensi dengan mediasi efikasi diri. Jurnal Sains Psikologi, 6(2), 68–74
  29. Nolan, T. S., Ivankova, N., Carson, T. L., Spaulding, A. M., Dunovan, S., Davies, S., Enah, C., & Meneses, K. (2022). Life after breast cancer: 'Being' a young African American survivor. Ethnicity & Health, 27(2), 247–274. https://doi.org/10.1080/13557858.2019.1682524
  30. Phillips-Salimi, C. R., & Andrykowski, M. A. (2013). Physical and mental health status of female adolescent/young adult survivors of breast and gynecological cancer: A national, population-based, case-control study. Supportive Care in Cancer, 21(6), 1597–1604. https://doi.org/10.1007/s00520-012-1701-7
  31. Purba, B., & Siahaan, E. M. R. (2023). Resilience in women with breast cancer. Innovative: Journal of Social Science Research, 3(4), 4123–4137
  32. Ristevska-Dimitrovska, G., Filov, I., Rajchanovska, D., Stefanovski, P., & Dejanova, B. (2015). Resilience and quality of life in breast cancer patients. Open Access Macedonian Journal of Medical Sciences, 3(4), 727–731. https://doi.org/10.3889/oamjms.2015.128
  33. Saboonchi, F., Petersson, L. M., Wennman-Larsen, A., Alexanderson, K., Brännström, R., & Vaez, M. (2014). Changes in caseness of anxiety and depression in breast cancer patients during the first year following surgery: Patterns of transiency and severity of the distress response. European Journal of Oncology Nursing, 18(6), 598–604. https://doi.org/10.1016/j.ejon.2014.06.007
  34. Sitio, R. (2019). Pengalaman psikososial pasien kanker payudara yang menjalani kemoterapi. Jurnal Keperawatan Priority, 2(1), 17–32
  35. Suwartono, H., Latief, J. A., Herman, A., & Napirah, M. R. (2025). Resilience as a Socially Embedded Process in Cervical Cancer Care: A Qualitative Study. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(10), 1241-1252. https://doi.org/10.56338/mppki.v8i10.8667
  36. Taheri, A., & Falavarjani, M. F. (2019). Hope, self-efficacy, and perceived stress among Iranian women with breast cancer: Examining the mediating role of resilience. Middle East Journal of Positive Psychology, 5(1), 82–96. https://www.middleeastjournalofpositivepsychology.org/index.php/mejpp/article/view/90
  37. Trayes, K. P., & Cokenakes, S. E. H. (2021). Breast cancer treatment. American Family Physician, 104(2), 171–178
  38. Ulibarri-Ochoa, A., Macía, P., Ruiz-de-Alegría, B., García-Vivar, C., & Iraurgi, I. (2024). The role of resilience and coping strategies in breast cancer patients. European Journal of Oncology Nursing, 71, 102620. https://doi.org/10.1016/j.ejon.2024.102620
  39. Wahyudi, A., Mahyuddin, M. J., Irawan, A. W., Silondae, D. P., Lestari, M., Bosco, F. H., & Kurniawan, S. J. (2020). Model rasch: analisis skala resiliensi connor-davidson versi bahasa indonesia. advice: Jurnal Bimbingan Dan Konseling, 2(1), 28. https://doi.org/10.32585/advice.v2i1.701
  40. Walsh, F. (2012). The new normal: Diversity and complexity in 21st-century families. Guilford Press
  41. Wang, H., Yue, H., Ren, M., & Feng, D. (2021). Dyadic effects of family functioning and resilience on quality of life. European Journal of Oncology Nursing, 52, 101963. https://doi.org/10.1016/j.ejon.2021.101963
  42. World Health Organization. (2022). Cancer
  43. Yang, C., Zhou, Y., Cao, Q., Xia, M., & An, J. (2019). The relationship between self-efficacy and resilience. Frontiers in Psychiatry, 10, 388. https://doi.org/10.3389/fpsyt.2019.00388
  44. Yuan, Y., Xu, H. W., Zhang, S., Wang, Y., Kitayama, A., Takashi, E., Gong, W. J., & Liang, J. Y. (2021). The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases. Nursing Open, 8(6), 3566–3574. https://doi.org/10.1002/nop2.906
  45. Zahara, A. R., & Minerty, B. P. (2021). Post-traumatic growth in women breast cancer survivors. Journal of Healthcare Technology and Medicine, 7(2). https://doi.org/10.33143/jhtm.v7i2.1756
  46. Zhang, Q., Xiao, S., Yan, L., Sun, L., Wang, Y., & Huang, M. (2019). Psychosocial predictors of adjustment to disability among patients with breast cancer: A cross-sectional descriptive study. The Journal of Nursing Research: JNR, 27(2), e15. https://doi.org/10.1097/jnr.0000000000000283
  47. Zhang Y. (2018). Family functioning in the context of an adult family member with illness: A concept analysis. Journal of Clinical Nursing, 27(15-16), 3205–3224. https://doi.org/10.1111/jocn.14500

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