Meaning in life mediates the association between post-traumatic growth and psychological resilience among cancer patients

Cancer constitutes a profound medical, psychological, and existential challenge. Although the illness experience is frequently associated with emotional distress and disruption of personal meaning, some patients report post-traumatic growth (PTG), reflecting positive psychological transformation following adversity. However, the relationships among PTG, meaning in life, and psychological resilience remain underexplored, particularly among Arab populations. The present study investigated whether meaning in life mediated the association between PTG and psychological resilience among cancer patients in Algeria and Yemen. Using a correlational cross-sectional design, 200 adult cancer patients undergoing active treatment were recruited from public oncology departments in Algeria ( n = 150) and Yemen ( n = 50). Interviewed by trained assistants, the participants completed Arabic versions of the Post-Traumatic Growth Inventory–Short Form, Connor–Davidson Resilience Scale-10, and Meaning in Life Scale. PTG was significantly associated with meaning in life (β = 0.252, p = .001), and meaning in life was significantly associated with resilience (β = 0.547, p < .001). In the cross-sectional mediation model, the indirect association between PTG and resilience through meaning in life was statistically significant (β = 0.138, p = .002, 95% CI [0.048, 0.223]), whereas the direct association was not statistically significant (β = 0.100, p = .172, 95% CI [− 0.048, 0.246]). The total association was statistically significant (β = 0.238, p = .008, 95% CI [0.052, 0.395]), with the indirect association accounting for approximately 58.0% of the total association. After adjustment for country, age, sex, marital status, education, disease stage, and disease duration, the indirect association remained statistically significant (β = 0.111, p = .014, 95% CI [0.029, 0.207]), whereas the direct association remained non-significant (β = 0.098, p = .192, 95% CI [− 0.053, 0.238]). This pattern was consistent with an indirect-only mediation pattern in the statistical model. No statistically significant differences were detected by nationality or sex. Meaning in life showed a significant mediating association between PTG and psychological resilience among cancer patients. The findings indicate that the association between PTG and resilience was statistically consistent with an indirect pathway through meaning in life, both before and after adjustment for the demographic and clinical covariates assessed. Given the cross-sectional design, these findings should not be interpreted as evidence of temporal or causal relationships among the variables. The findings provide a rationale for prospectively investigating meaning-centered psychosocial approaches in oncology care, including in Arab contexts.