Psychological Resilience in Colorectal Cancer Patients: A Comprehensive Mixed Methods Systematic Review.

AIM

To identify facilitators and barriers that influence psychological resilience among colorectal cancer (CRC) patients.

DESIGN

Mixed-methods systematic review.

DATA SOURCES

Eight databases were searched (1987-2026): CINAHL Plus, Scopus, PubMed, PsycINFO, EMBASE, Cochrane Library, Web of Science, and Medline.

METHODS

A data-based convergent synthesis was conducted in accordance with Joanna Briggs Institute guidelines. Study selection and quality appraisal (using the MMAT tool) were completed in Covidence, and data extraction and transformation were managed in Covidence and NVivo.

RESULTS

A total of 33 studies were included. Guided by the Society-to-Cells Resilience Framework, identified multilevel facilitators and barriers shaping resilience among CRC survivors. Six interventions demonstrated effectiveness in enhancing resilience among CRC survivors: the resilience-base prehabilitation program, the resilience and nutrition program, the narrative therapy and resilience training program, the Hospital-Family Holistic Care Model, Physiotherapy, and Attention and Interpretation Therapy (AIT). Resilience was supported by healthcare systems, family, positive cognitive and emotional resources, good self-management, and a lower symptom burden. Barriers included healthcare disparities, limited support, psychological distress, stigma, poor self-care, and increased fatigue. Notably, three factors (coping style, urban residence, employment) varied dynamically across contexts, acting as either facilitators or barriers.

CONCLUSIONS

Psychological resilience in CRC care is multidimensional and context-dependent, shaped by the interplay of societal, community, family, individual, and physiological and cellular factors. These findings underscore the urgent need for multilevel, person-centred interventions to strengthen resilience across the cancer care continuum. Future research should focus on longitudinal and qualitative studies to inform targeted strategies.

TRIAL REGISTRATION

CRD42023470691.

© 2026 John Wiley & Sons Ltd.