Trajectories and determinants of family resilience following radical surgery for gynecological malignancies: A prospective longitudinal study.

Objective: This study aimed to examine the longitudinal trajectories of family resilience within six months after radical surgery for gynecological malignancies and to identify predictors associated with these trajectories. Methods: A total of 243 patients with gynecological malignancies undergoing radical hysterectomy were recruited through convenience sampling at a tertiary hospital in Guangzhou, China, between May 2024 and March 2025. Family resilience was assessed at four time points (preoperatively, and at 1, 3, and 6 months post-surgery) using the Chinese version of the Family Resilience Assessment Scale. Additional measures included the Perceived Social Support Scale, the Perceived Stress Scale-14, and the Family APGAR Scale. Growth mixture modeling (GMM) was applied to identify distinct family resilience trajectories, and binary logistic regression was used to determine predictors of trajectory membership. Results: Mean family resilience scores were 71.40 ​± ​9.84 (baseline), 68.42 ​± ​10.66 (1 month), 68.99 ​± ​12.43 (3 months), and 68.65 ​± ​13.65 (6 months). Two distinct trajectory classes emerged: a "high-level slow-increase" group and a "low-level continuous-decline" group. Higher baseline monthly family income and greater perceived social support predicted membership in the high-level slow-increase group, whereas higher baseline perceived stress predicted membership in the low-level continuous-decline group Conclusions: Family resilience trajectories following radical surgery for gynecological malignancies demonstrate significant heterogeneity. Early identification of individuals with low family income, low perceived social support, and high perceived stress is essential to guide timely, targeted interventions that promote adaptive family functioning.