Impact of social support on demoralization in patients with gynecological cancer: The chain mediating role of resourcefulness and resilience

Objective: To explore the association between social support and demoralization and how resourcefulness and resilience mediate this relationship. Methods: A convenience sampling method was used. A cross-sectional study was conducted among 343 gynecological cancer patients in three hospitals in Hunan Province, China, from October 2024 to March 2025. The Social Support Scale, Demoralization Scale, Resourcefulness Scale, and Resilience Scale were used to collect data. Data analysis was conducted via descriptive statistical analysis, Spearman correlation analysis, and regression analysis to estimate direct and indirect effects via bootstrap analysis. Results: ​< ​0.001). Social support indirectly affected demoralization through three mediating pathways: resourcefulness (effect ​= ​-0.020; standard error ​= ​0.022; 95% confidence interval [CI] [-0.064, -0.024]), resilience (effect ​= ​-0.037; standard error ​= ​0.015; 95% CI [-0.072, -0.013]), and the resourcefulness-resilience pathway (effect ​= ​-0.038; standard error ​= ​0.013; 95% CI [-0.070, -0.018]). The indirect effect accounted for 18.35% of the total effect. Conclusions: We proved that resourcefulness and resilience mediated some of the effects of social support on demoralization. The findings of this study have implications for interventions to promote the social support of gynecological cancer patients and, in particular, to enhance resourcefulness and resilience.