Surabaya – Strong social support from family and surrounding communities, combined with confidence in managing one's illness, plays a vital role in helping adults with chronic diseases remain resilient despite ongoing health challenges. In contrast, depression, anxiety, and disease-related psychological distress consistently weaken patients' ability to adapt and recover. These findings were reported by Ananda Putri, Suhadianto, and I Gusti Ayu Agung Noviekayati from the Faculty of Psychology at the University of 17 Agustus 1945 Surabaya in a study published in 2026 in the International Journal of Scientific Multidisciplinary Research (IJSMR). Through a systematic literature review, the researchers concluded that resilience among individuals living with chronic illness is shaped by the interaction of psychological, spiritual, social, clinical, and sociodemographic factors, all of which can be strengthened through appropriate interventions.
Chronic illnesses such as diabetes mellitus, chronic kidney disease, cardiovascular disease, cancer, stroke, and chronic obstructive pulmonary disease (COPD) affect far more than physical health. Patients often face lifelong treatment, limitations in daily activities, fluctuating symptoms, and uncertainty about the future. These ongoing challenges frequently lead to stress, anxiety, depression, and a reduced quality of life if patients are unable to develop effective coping strategies.
The study explains that people respond differently to chronic illness. While some patients struggle psychologically, others remain optimistic, adhere consistently to treatment, and maintain a satisfying quality of life despite significant physical limitations. This adaptive capacity is known as resilience—the ability to recover, adjust, and continue functioning positively when facing adversity. According to the researchers, resilience is not a fixed personality trait but a dynamic capability that can be strengthened through experience, environmental support, and psychological intervention.
To identify the determinants of resilience, the researchers conducted a Systematic Literature Review (SLR) following the PRISMA 2020 and Joanna Briggs Institute (JBI) 2020 guidelines. Literature searches were performed across six major databases—PubMed, Web of Science, Scopus, PsycINFO, EBSCO, and Google Scholar—for studies published between 2020 and 2026. From 3,818 identified publications, only 26 empirical studies met all inclusion criteria and were synthesized using a structured narrative approach.
The review found that resilience is influenced by five major domains: psychological, spiritual, social, clinical, and sociodemographic factors. Among these, social support and self-efficacy emerged as the strongest and most consistent positive predictors across various chronic diseases. Conversely, depression, anxiety, and illness-related psychological distress consistently reduced resilience, making it more difficult for patients to cope with long-term health challenges.
Within the psychological domain, patients with strong self-efficacy—confidence in their ability to manage their illness—demonstrated greater resilience. These individuals were more likely to adhere to treatment plans, actively solve health-related problems, and maintain optimism despite ongoing medical challenges. On the other hand, depression and anxiety impaired patients' ability to perceive illness as a manageable challenge, reducing adaptive coping and psychological recovery.
The review also highlights the significant contribution of spirituality. Spiritual beliefs, religious practices, hope, and the ability to find meaning in the experience of illness consistently strengthened resilience, particularly among patients with chronic kidney disease and cancer. Patients with higher levels of spiritual well-being generally showed greater emotional stability and stronger motivation to continue treatment despite uncertainty about their condition.
Among all identified determinants, social support demonstrated the greatest consistency across the reviewed studies. Support from family members, spouses, friends, and healthcare professionals helped patients feel less isolated, reduced emotional distress, encouraged treatment adherence, and strengthened confidence in managing chronic illness. Several studies even identified perceived social support as the single strongest predictor of resilience among individuals living with long-term medical conditions.
The researchers also found that clinical factors, including symptom severity, disease-related stress, physical functioning, self-management ability, and overall perceived health status, influenced resilience. Patients experiencing fewer symptoms, greater independence in daily activities, and better disease management tended to exhibit stronger resilience. In contrast, sociodemographic factors such as age, educational background, and socioeconomic status showed weaker and less consistent relationships with resilience, suggesting that psychological and social resources play a much larger role than demographic characteristics alone.
Drawing together evidence from all 26 studies, the researchers concluded that social support is the most robust determinant of resilience among adults with chronic illness. Self-efficacy also plays a central role by encouraging adaptive coping strategies, while depression and anxiety undermine patients' psychological capacity to deal with illness. These findings suggest that resilience-building interventions should not focus solely on individual patients but should actively involve family members and broader social support networks.
Based on the review findings, the authors recommend implementing multicomponent resilience-based interventions that integrate self-efficacy enhancement, family support programs, self-management training, psychological counseling, and culturally appropriate spiritual resources. They also recommend routine screening for depression, anxiety, self-efficacy, and available social support so that patients at greater psychological risk can receive early intervention before emotional problems become more severe.
Overall, the study demonstrates that resilience in adults with chronic disease depends on far more than medical treatment alone. Psychological strength, supportive relationships, and spiritual resources together enable patients to adapt more effectively, maintain emotional well-being, improve adherence to long-term treatment, and achieve a better quality of life despite living with chronic health conditions.
Author Profile
Ananda Putri – Faculty of Psychology, University of 17 Agustus 1945 Surabaya, Indonesia.
Suhadianto – Faculty of Psychology, University of 17 Agustus 1945 Surabaya, Indonesia.
I Gusti Ayu Agung Noviekayati – Faculty of Psychology, University of 17 Agustus 1945 Surabaya, Indonesia.
Research Source
Article Title: Determinants of Resilience among Adults with Chronic Disease: A Systematic Literature Review.
Journal: International Journal of Scientific Multidisciplinary Research (IJSMR), Vol. 4, No. 7, 2026.
DOI: https://doi.org/10.55927/ijsmr.v4i7.111
Journal Website: https://journalijsmr.my.id/index.php/ijsmr
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