Objective To analyze the relationship between couple illness communication and family resilience in gynecological malignancy patients and their spouses.

Methods A total of 800 couples with gynecological malignancies who were admitted to the inpatient department of a tertiary grade A hospital in Anhui Province from March 2022 to March 2024 were selected as the research subjects. A questionnaire survey was conducted using cancer-related communication problems scale and family hardiness index.

Results Thecouple illness communication scores of gynecologicalmalignancy patients and their spouses were basically consistent (P ＞ 0.05), while the family resilience scores of patients were lower than those of their spouses (P ＜ 0.01). The total scores ofcouple illness communication were negatively correlated with total scores of family resilience between the patients and their spouses (P ＜ 0.05 to P ＜ 0.01). Thecouple illness communication of gynecologicalmalignancy patients could negatively predict their own family resilience (β = –0.256, P ＜ 0.01), and could also negatively predict the family resilience of their spouses (β = –0.120, P ＜ 0.01). Thecouple illness communication of spouses could negatively predict the family resilience of both the patients and their spouses (β = –0.328, –0.199, P ＜ 0.01).

Conclusions The level of family resiliencein couples with gynecologicalmalignancies isinteractively influenced by both their own and their spouses' level ofcouple illness communication.Therefore, spouses should be included in disease management strategies, and the binary interaction between couples should be emphasized. From the perspective of illness communication, more targeted interventions should be actively explored to guide mutual support and collaboration between both parties, thereby enhancing family resilience.