Associations of body image with depressive symptoms and PTG among breast cancer patients: The mediating role of social support

Abstract

BackgroundCancer diagnosis and treatment usually trigger positive and negative psychological health outcomes. Social support is a coping resource for psychological health outcomes. However, little research is available on the relationships between social support, body image, and overall psychological health outcomes in breast cancer (BC) patients. This study aimed to estimate the prevalence of depressive symptoms and post-traumatic growth (PTG) and examine the mediating roles of social support between body image and depressive symptoms and PTG among BC patients, respectively.MethodsA cross-sectional study was conducted in the Northeast China from December 2015 to August 2017. All the participants were diagnosed with BC and underwent surgery. This study was conducted with 405 BC patients from the First Affiliated Hospital of China Medical University. Participants completed the Center for Epidemiologic Studies Depression scale, Post Traumatic Growth Inventory, Body Image Scale, and Perceived Social Support Scale. The associations of social support, body image with depressive symptoms, and PTG were examined by hierarchical linear regression analysis. Asymptotic and resampling strategies were used to explore the mediating role of social support.ResultsThe prevalence of depressive symptoms was 88.1%, and 67.2% of the patients had moderate-high PTG, 52.84% of the patients had body concerns, and 264 (65.19%) patients had high-level social support. Body image was positively associated with depressive symptoms (β = 0.445, P < 0.001) and social support was negatively associated with depressive symptoms (β = −0.219, P < 0.001). Body image was negatively associated with PTG (β = −0.095, P = 0.023), whereas social support was positively associated with PTG (β = 0.533, P < 0.001). Social support significantly mediated the associations among body image, depressive symptoms (effect size = 0.057), and PTG (effect size = −0.304), respectively.ConclusionsSocial support played mediating role in the relationships between body image and depressive symptoms and PTG. The interventions based on social support and body image should be included in psychological health prevention.

Predictors of Posttraumatic Growth in Cancer Patients Post Treatment

“…No association with recurrence was found in a population-based study in Germany (Liu et a., 2021). Higher posttraumatic growth was reported by Cormio et al (2017) in patients without comorbidities, and by Li (2022) in patients without metastases. The inconsistent findings may be related to differences in the level of institutional care in different countries or regions.…”

“…In cancer patients, posttraumatic growth is also examined in the context of socio-demographic characteristics and specific clinical markers that are directly related to the disease. Higher levels of posttraumatic growth have been identified in women (e.g., Romeo et al, 2022) and in cancer patients in a partnership or marriage (e.g., Li, 2022;Mystakidou et al, 2008). Cormio et al (2015) did not find empirical support for the findings above.…”

“…Cancer patients report many negative consequences of their disease and treatment, including unmet physical and daily living needs, fear of disease progression (Nik Jaafar et al, 2022), or depressive experience (Heidarzadeh et al, 2016;Li, 2022;Romeo et al, 2022). According to the aforementioned research, all of these difficulties are associated with lower levels of posttraumatic growth.…”

“…In addition to the negative aspects of patients' experiences, some research has also focused on constructs that are central to positive psychology. For instance, posttraumatic growth in cancer patients has been found to be related to hope (Baglama & Atak, 2015;Heidarzadeh et al, 2016;, humor , self-esteem and optimism (Lisica et al, 2019), happiness (Lelorain et al, 2010), positive affectivity (Lelorain et al, 2010), coping focused on positive emotions and problem solving (Kroemeke et al, 2017), and social support (Li, 2022). To a lesser extent, research has focused on relationship-oriented gratitude (Ruini & Vescovelli, 2013) or forgiveness.…”

Identifikasi Kebutuhan Psikoedukasi untuk Menurunkan Distres Psikologis pada Wanita dengan Kanker Payudara Pasca Mastektomi

“…Faktor psikologis yang paling banyak adalah masalah citra tubuh yang berhubungan positif dengan gejala depresi. Hal ini sesuai penelitian yang menunjukkan bahwa 52,84% pasien dengan masalah citra tubuh mengalami depresi sedang (Li, 2022). Depresi yang disebabkan oleh rasa malu pasien karena kehilangan payudara dapat berdampak pada kesejahteraan fisik, kesejahteraan emosional, kesejahteraan sosial, dan strategi koping (Alhusban, 2019).…”