尽管之前的研究揭示了强大癌症幸存者的弹性与生活质量之间存在正向关联，但两者的关系机制尚不清楚。本研究旨在探索弹性、社会支持、灵性与生活质量之间的关系，并确定社会支持和灵性对弹性与生活质量之间关系的多重中介效应。使用方便抽样，采用横断面相关调查法，对286名强大癌症幸存者进行评估。通过自我报告问卷评估了弹性、社会支持、灵性和生活质量。使用SPSS软件的PROCESS宏包测试了多重中介模型。 弹性、社会支持、灵性和生活质量的得分之间呈正相关。研究发现弹性直接影响生活质量。同时，弹性与生活质量之间的关系分别通过社会支持（效应=0.067，95％CI [0.019, 0.120]）和灵性（效应=0.221，95％CI [0.134, 0.332]）中介，并通过这两者依次中介（效应=0.036，95％CI [0.015, 0.067]）。 社会支持和灵性在弹性与生活质量之间的关系中扮演了多重中介角色。增加弹性，进而增强社会支持和灵性的干预措施可能有助于促进强大癌症幸存者的生活质量。 版权所有 © 2023 Chen, Sun, Liu, Jiao, Wei and Hu.

While previous studies have revealed a positive association between resilience and quality of life in advanced cancer survivors, the mechanisms of the relationship is still unclear. This study aimed to explore the relationships between resilience, social support, spirituality, and quality of life and determine the multiple mediation effects of social support and spirituality on the relationship between resilience and quality of life.With 286 advanced cancer survivors, a cross-sectional, correlational survey was adopted using convenience sampling. Resilience, social support, spirituality, and quality of life were evaluated by self-report questionnaires. The PROCESS macro for SPSS was used to test the multiple mediation model.The scores for resilience, social support, spirituality and quality of life were positively correlated with one another. Resilience was found to be directly impact quality of life. Meanwhile, the relationship between resilience and quality of life was mediated by social support (effect = 0.067, 95% CI [0.019, 0.120]) and by spirituality (effect = 0.221, 95% CI [0.134, 0.332]), respectively, and by these two serially (effect = 0.036, 95% CI [0.015, 0.067]).Social support and spirituality played multiple mediating roles in the relationship between resilience and quality of life. Interventions aimed at increasing resilience, and then boosting social support and spirituality may be beneficial for promoting quality of life of advanced cancer survivors.Copyright © 2023 Chen, Sun, Liu, Jiao, Wei and Hu.