Substantive theory of family resilience among couples dealing with prostate cancer: A grounded theory study

Family resilience is a dynamic process through which families rebound from adversity and restore or reestablish equilibrium. As family resilience is shaped by cultural factors, this study aimed to develop a substantive theory of family resilience among Taiwanese couples facing prostate cancer.

Guided by grounded theory methodology and theoretical sampling, this qualitative study conducted individual semi-structured interviews with prostate cancer patients and their spouses from August 2023 to January 2025. Interviews were conducted sequentially, with patients interviewed first, followed by their spouses. The data analysis process involved repeated reading and constant comparison to identify emerging meanings. Transcripts were analyzed through open coding, axial coding, and selective coding to develop the substantive theory. Interviewing and data analysis were performed concurrently and continued until theoretical saturation was achieved.

Seventeen couples participated in the study. The core category identified was "The Process of Family Resilience: Activation, Reinforcement, and Adjustment." This core category connected five major categories: "seeking medical care and diagnosis," "adverse impacts," "outcomes," "influencing factors," and "context." The family resilience of couples dealing with prostate cancer is strongly affected by context and influencing factors.

This study proposes a substantive theory of family resilience in the context of prostate cancer, offering healthcare professionals deeper insight into family resilience processes and guiding the development of targeted care strategies. The findings further highlight how cultural norms and family roles shape family resilience processes among Taiwanese couples with prostate cancer.