Psychosocial adjustment of cancer survivors is one of the essential dimensions of post-treatment care, which goes beyond controlling physical symptoms, is related to the individual's ability to return to family, social, occupational, and individual roles and create a new balance in life. The end of cancer treatment does not necessarily mean the end of the psychological consequences of the disease, and many survivors may continue to face fear of recurrence, health anxiety, fatigue, body image changes, worry about the future, and disruption in social relationships. From this perspective, developing a model of psychosocial adjustment can help identify individual and interpersonal sources affecting the quality of adjustment. In the framework of psycho-oncology, self-efficacy, resilience, and social support are among the variables that can explain the adaptation path of cancer survivors in interaction with each other.
Self-efficacy refers to an individual's belief in their ability to manage difficult situations, solve problems, and achieve goals. In cancer survivors, self-efficacy can play a role in managing lasting complications of treatment, regulating emotion, pursuing medical care, returning to daily activities, and facing concerns related to recurrence. A person who considers himself more capable of managing cancer outcomes is more likely to use active coping strategies and not become passive in the face of problems after treatment. Therefore, self-efficacy can be one of the main pathways in the psychosocial adaptation model and help improve psychological and social functioning by increasing a sense of control and reducing perceived helplessness.
Resilience also refers to an individual's capacity to maintain or recover adaptation in situations of stress and crisis. The experience of cancer can affect a person's belief system and expectations about health, future, and security, but individuals are not the same in terms of their ability to rebuild psychological balance after this experience. Resilience helps the survivor maintain his or her resilience and readjust the course of life based on new circumstances despite existing limitations and uncertainties. In the conceptual model of adaptation, resilience can act as both a direct factor and a mediating variable between individual resources and psychosocial consequences. Increasing resilience can pave the way for more effective use of coping, emotion regulation, and problem-solving skills.
The relationship between self-efficacy and resilience can also be reciprocal and reinforcing. When a survivor experiences successes in the face of problems after treatment, their sense of empowerment increases, and this successful experience can strengthen resilience capacity. On the other hand, the resilient person may not interpret temporary setbacks and limitations as a sign of lasting disability, thereby maintaining better self-efficacy. This interaction can create an adaptive cycle in which feelings of empowerment, resilience, and active participation in each other's lives reinforce each other.
Social support is the third most important component of this model and includes emotional, informational, practical and social support from family, friends, colleagues, peer groups, and the healthcare system. Social support can reduce the stress of illness and provide resources to cope with problems after treatment. Having safe and trusting relationships allows the survivor to voice their concerns, reduce loneliness, and use external resources in difficult situations. In contrast, social isolation or disproportionate support can increase feelings of vulnerability and dependence, making the adjustment process more complicated.
Social support can also influence adaptation through increased self-efficacy. When a person is faced with realistic encouragement, acceptance, and support in a family or community setting, they are more likely to believe in their abilities and take action to return to daily activities. Positive feedback and appropriate support can foster a sense of worthiness, while extreme support and compassionate behavior may reduce a person's independence. Therefore, in developing an adaptation model, the quality of social support and the individual's perception of it are more important than just the number of social relationships.
Structurally, it can be assumed that self-efficacy and resilience have a direct effect on psychosocial adaptation, and social support affects adaptation by strengthening these individual resources in addition to the direct effect. Resilience may also play a mediating role in the relationship between social support and adaptation, meaning that social support creates more desirable psychosocial consequences by strengthening coping resources and resilience. Self-efficacy can also be considered as a mediating variable in the relationship between resilience and adaptation, as the resilient person may feel more in control and empowerment as a result of experiencing success in crisis management.
In this model, psychosocial adjustment is a multidimensional outcome and cannot be measured solely by reducing anxiety or depression. Optimal adaptation can include reducing psychological distress, increasing life satisfaction, returning to social roles, improving family relationships, participating in daily activities, increasing independence, and forming a realistic attitude toward the future.
The application of this model in psycho-oncology can help design targeted interventions. The specialist can first assess the individual's level of self-efficacy, resilience, and social support, and then adjust the intervention based on the prevailing need. For a person who feels powerless, strengthening self-efficacy through gradual goal setting and experiencing achievable successes is more important, while for a person with a weak support network, building relationships with family, peer groups, or social services may be a priority. In cases where psychological resilience is low, coping skills training, emotion regulation, acceptance, and problem-solving can help strengthen resilience.
However, the adaptation model must also take into account individual and contextual differences. Type of cancer, stage of disease, severity and duration of treatment, physical complications, age, employment status, economic conditions, quality of family relationships, and access to psychological services can alter the course of adaptation. Therefore, self-efficacy, resilience, and social support cannot be expected to have the same effect on all survivors. Also, successful adjustment does not necessarily mean a complete return to the pre-disease state, but it can mean the creation of a new and acceptable balance that is aligned with the post-cancer condition.
The psychosocial adjustment model of cancer survivors based on self-efficacy, resilience, and social support can provide a multi-level framework for understanding the post-treatment process. In this framework, self-efficacy represents the source of individual empowerment, resilience represents the capacity to maintain and reconstruct psychological balance, and social support represents interpersonal and environmental resources. The interaction of these three components can provide the ground for reducing psychological vulnerability, increasing social participation, gradual return to life roles, and improving the quality of life. From the perspective of psycho-oncology, simultaneous attention to these three sources causes the cancer survivor to be considered not only as an individual who has gone through the disease, but also as a human being rebuilding his identity, relationships, and functioning after a life-threatening experience.