Barriers and facilitators to resilience for rural cancer survivors during COVID-19.

The purpose of this study was to identify the barriers and facilitators of resilience for rural cancer survivors during COVID-19. A descriptive qualitative study design was used to achieve the study objected. We recruited six posttreatment cancer survivors, four caregivers of cancer survivors, and one survivor who also identified as a caregiver, all from rural Southwest Virginia. Participants completed 60-90 minute virtual interviews that were recorded, transcribed, and verified in Dedoose qualitative software. Data was analyzed using an inductive and deductive coding strategies, and thematic analysis was used to develop key themes. Four key themes emerged from the data: 1) Religious faith is a primary source of resilience, 2) Spiritual cancer care strengthens resilience, 3) Virtual platforms provide critical connections to faith communities, and 4) Fearful and fatalistic cancer beliefs reduce resilience. The findings provide critical descriptive evidence that faith facilitates resilience for rural cancer survivors, while rural cultural norms of fearful and fatalistic cancer beliefs reduce resilience. In the context of COVID-19, rural survivors prioritize utilizing virtual support groups to strengthen their resilience. Nurses should incorporate a spiritual assessment into survivorship care, and guide survivors to existing virtual support groups.