Consensus Development of Resilience Components in Malaysian Breast Cancer Survivors: Findings from a Delphi Study

Abstract

INTRODUCTION: Resilience significantly influences the mental health and treatment outcomes of cancer patients. This study aimed to establish expert consensus on key resilience components specific to Malaysian breast cancer survivors using a Delphi method. MATERIALS AND METHODS: A Three-Round Modified Delphi Technique was conducted on 10 expert panelists involving psychiatrists, psychologists, and breast cancer survivors. In Round 1, open-ended questions identified initial resilience components. In Rounds 2 and 3, panelists rated the importance of each component using a 5-point Likert scale. Consensus was defined as a mean score ≥4.0 with at least 75% agreement. Both median scores and percentage agreement were used to ensure reliability. RESULTS: The final framework consisted of 10 main components and 25 subcomponents, with two subcomponents excluded due to low consensus. Main components included emotional, cognitive, knowledge, physical, religious and spirituality, social support, family support, mental health, financial, and other relevant domains. Endorsed subcomponents included emotional flexibility, self-regulation, optimism, gratitude, knowledge of cancer, physical health, religious coping, spiritual practices, social and family support, mental health self-efficacy, and financial status. CONCLUSION: This expert-endorsed framework offers a culturally relevant foundation for developing resilience-building strategies among Malaysian breast cancer survivors. These identified components may guide future psychosocial interventions aimed at improving emotional well-being and treatment outcomes among breast cancer survivors