Background: Psychological resilience is considered a dynamic process or outcome. Most studies that have examined the psychological resilience of prostate cancer survivors have used cross-sectional designs, limiting the understanding of changes in psychological resilience across different stages of the disease.

Objectives: To investigate changes in psychological resilience and demoralization among newly diagnosed prostate cancer survivors from before treatment to 1 year after treatment initiation as well as the associated influencing factors.

Methods: A longitudinal design was adopted, and cases were collected from the outpatient department. Data collection occurred at four time points: prior to treatment after the treatment decision was made and at 3, 6, and 12 months after treatment. Study variables included demographic characteristics, disease characteristics, physical symptoms, fear of cancer recurrence, social participation, cancer-related self-efficacy, psychological resilience, and demoralization.

Results: The psychological resilience and demoralization scores of prostate cancer survivors at 3, 6, and 12 months after treatment were similar to their scores before treatment. Survivors with higher fear of cancer recurrence and lower cancer-related self-efficacy had poorer psychological resilience and more severe demoralization. Severe hormonal symptoms and lower interpersonal relationship activity participation were associated with more severe demoralization in survivors with prostate cancer.

Conclusions: Fear of cancer recurrence, self-efficacy, hormonal symptoms, and interpersonal activity participation are associated with psychological resilience and demoralization.

Implications for practice: Assessing psychological resilience and demoralization is crucial in prostate cancer care. Integrated self-management interventions that address physical, psychological, and social aspects can enhance survivors' resilience.

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