# Psychosocial Aspects of Cystic Fibrosis: A Mixed-Methods Systematic Review

## TL;DR

This review shows that as people with cystic fibrosis live longer, their mental health and social challenges become increasingly important and need better support.

## Contribution

The study updates the understanding of psychosocial challenges in adults with cystic fibrosis and emphasizes the need for integrated care models.

## Key findings

- Optimistic coping is the most frequent strategy linked to improved survival in CF patients.
- High social support and gratitude are key factors for treatment adherence and quality of life.
- Depression is the primary mental health concern, and financial stress and stigma are major psychosocial challenges.

## Abstract

What are the main findings?
Psychosocial aspects (e.g., coping, social support) were identified as central to the CF patient experience, shifting the focus beyond biological survival.Advances in treatment have significantly increased life expectancy, introducing new psychosocial challenges for adults with CF (e.g., management of visible symptoms, stigma in the workplace, financial instability).

Psychosocial aspects (e.g., coping, social support) were identified as central to the CF patient experience, shifting the focus beyond biological survival.

Advances in treatment have significantly increased life expectancy, introducing new psychosocial challenges for adults with CF (e.g., management of visible symptoms, stigma in the workplace, financial instability).

What are the implications of the main findings?
There is a need for integrated care models that address both clinical symptoms and psychosocial factors, such as reproductive goals and financial literacy, to support CF patients as they transition into adulthood.Digital and group psychological interventions are important to foster universality and boost peer connection, while maintaining clinical safety to prevent cross-contamination between CF patients.

There is a need for integrated care models that address both clinical symptoms and psychosocial factors, such as reproductive goals and financial literacy, to support CF patients as they transition into adulthood.

Digital and group psychological interventions are important to foster universality and boost peer connection, while maintaining clinical safety to prevent cross-contamination between CF patients.

Background/Objectives: Cystic fibrosis (CF) is a genetic condition with an increasing life expectancy in recent years. As a result, addressing psychosocial aspects in this population has become an increasingly important concern. This mixed-methods systematic review aimed to update the current knowledge on the psychosocial aspects of living with CF in adults. Methods: Following PRISMA guidelines, a literature search was conducted in November 2024 across several databases, including Scopus, ScienceDirect, Academic Search Complete, MEDLINE, Supplemental Index, Complementary Index, APA PsycInfo, Business Source Complete, SciELO, and the Directory of Open Access Journals via EBSCO. Results: Of the 701 articles retrieved, 24 were analyzed, including a total of 2023 participants (mean age: 31.2 years; 57.2% female). Quantitative findings identified optimistic coping as the most frequent strategy associated with improved survival. High social support and gratitude emerged as key factors for treatment adherence and quality of life, while depression remained the primary mental health concern. Qualitatively, the findings highlighted concerns with adult life transitions and financial stressors. Participants described experiences of social stigma and embarrassment linked to chronic symptoms, often leading to selective disclosure to avoid discrimination. Conclusions: This review confirms that psychosocial factors are central to the adult CF experience, shifting the focus beyond biological survival and highlighting areas that require clinical intervention. As life expectancy increases, clinical care must evolve to incorporate interventions that address these factors to improve mental health and overall quality of life (QoL), ensuring that patients are supported through the unique challenges of extended adulthood.