_______________________________________________________________________________________________________________________________ OA Maced J Med Sci. 2015 Dec 15; 3(4):727-731. 727 ID Design 2012/DOOEL Skopje Open Access Macedonian Journal of Medical Sciences. 2015 Dec 15; 3(4):727-731. http://dx.doi.org/10.3889/oamjms.2015.128 eISSN: 1857-9655 Public Health Resilience and Quality of Life in Breast Cancer Patients Gordana Ristevska-Dimitrоvska 1* , Izabela Filov 1 , Domnika Rajchanovska 1 , Petar Stefanovski 2 , Beti Dejanova 3 1 University St. Kliment Ohridski Bitola, Higher Medical School Bitola, Bitola, Republic of Macedonia; 2 Clinical Hospital Dr. Trifun Panovski, Department of Oncology, Bitola, Republic of Macedonia; 3 Department of Medical and Experimental Physiology with Anthropology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia Citation: Ristevska-Dimitrоvska G, Filov I, Rajchanovska D, Stefanovski P, Dejanova B. Resilience and Quality of Life in Breast Cancer Patients. OA Maced J Med Sci. 2015 Dec 15; 3(4):727-731. http://dx.doi.org/10.3889/oamjms.2015.128 Key words: resilience; quality of life; breast cancer; Connor Davidson Resilience Scale; EORTC QLQ-C30. * Correspondence: Dr. Gordana Ristevska-Dimitrоvska. University St. Kliment Ohridski Bitola, Higher Medical School Bitola, Vasko Karangjelevski bb, Bitola 7000, Republic of Macedonia. Phone: +38971294310. E-Mail: gordana.md@gmail.com Received: 20-Nov-2015; Revised: 28-Nov-2015; Accepted: 07-Dec-2015; Online first: 08-Dec-2015 Copyright: © 2015 Gordana Ristevska-Dimitrоvska, Izabela Filov, Domnika Rajchanovska, Petar Stefanovski, Beti Dejanova. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The authors have declared that no competing interests exist. Abstract BACKGROUND: Many studies have shown that a relationship exists between quality of life (QoL) and resilience in breast cancer patients, but few studies present information on the nature of this relationship of resilience on QoL. Our aim was to examine the relationship between resilience and quality of life in breast cancer patients. METHODS: QoL was measured in 218 consequent breast cancer patients, with EORTC - QLQ Core 30 questionnaire, and EORTC QLQ-BR23. The resilience was measured with Connor Davidson Resilience Scale. RESULTS: The global quality of life was positively correlated with the levels of resilience (R = 0.39 p < 0.001). All functional scales (physical, role, emotional, cognitive and social functioning was in a positive correlation with resilience. The symptoms severity (fatigue, nausea and vomitus, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) was in negative correlation with resilience. Less resilient breast cancer patients reported worse body image and future perspective and suffered from more severe adverse effects of systemic therapy, and arm/breast symptoms. CONCLUSION: Our findings show that psychological resilience affects different aspects of health- related quality of life. More resilient patients have significantly better quality of life in almost all aspects of QoL. Introduction Resilience Psychological resilience represents an ability of a person to protect his/her mental health when faced with adversity such is the cancer diagnosis. Adversity, through resilience mechanisms, can be reframed and become a possibility that one can learn and even benefit from. Psychiatry, as well as psychology, have repeatedly addressed the negative outcomes derived from cancer experience, such as depression, post-traumatic stress symptoms as well as anxiety [1]. But, very little is known about, what drives people to fight, survive and grow, when faced with cancer. When describing the cancer experience, one can approach resilience from several aspects [2]. We can approach to resilience as a baseline characteristic, a personality trait that enables individual to maintain mental health when exposed to stressful situation [3, 4]. People who are full of optimism, hope, are motivated and have solid social support system prior to the adversity, may be considered as more resilient [5, 6]. Second way of understanding resilience is to view it as a mechanism, which a person can use to adapt and protect good mental health [7]. Another way of understanding resilience is if we measure it as an outcome, as a consequence of adversity [8]. When resilience represents consequence, there is no way for an individual to know if he/she is resilient until faced with adversity. Cancer survivors, who are more optimistic and hopeful for the future, cope better with cancer and even experience personal growth [9-13]. We can expect that breast cancer survivors, who are married [14, 15], have bigger and better social support system [16-18], and have positive coping styles [19], to be