Construction of the structural equation model of stigma, self-disclosure, social support, and quality of life of breast cancer patients after surgery—a multicenter study

Abstract

PurposeStigma is common in patients with breast cancer after surgery, which has a negative impact on the quality of life (QOL). This study aimed to investigate the QOL of breast cancer patients after surgery and to analyze the multiple chains mediating effects of self-disclosure and social support between stigma and QOL.MethodsA total 292 patients of breast cancer patients after operation were recruited in this study. A questionnaire survey was conducted using the general information questionnaire, the consumer experiences of stigma questionnaire (CESQ), the distress disclosure index(DDI), the perceived social support scale(PSSS), and the functional assessment of cancer therapy-breast(FACT-B). Path analysis was conducted to test the hypothesized serial multiple mediation model.ResultsThe total scores of stigma, self-disclosure, social support and QOL were 15 (10 ~ 22), 39 (31 ~ 46), 58 (50 ~ 67) and 88 (74 ~ 104) respectively. QOL of breast cancer patients after the operation was negatively correlated with stigma (p < 0.01), and positively correlated with self-disclosure and social support (p < 0.01). Self-disclosure and social support played a complete mediating effect between stigma and QOL, and the total mediating effect value was 85. 87%.ConclusionsSelf-disclosure and social support play a complete intermediary role between stigma and QOL. In order to improve the quality of life of patients, medical staff should pay attention to the assessment of stigma, encourage patients to express their emotions, and encourage their families and friends to respond to their expression and needs of patients.

A study of the mediating effect of social support on self-disclosure and demoralization in Chinese older adult homebound breast cancer patients

“…Social support of older adult homebound breast cancer patients was positively correlated with self-disclosure. This indicates that the more social support patients receive, the higher the self-disclosure level, which is consistent with Bu et al (2023) . Social support is crucial in sustaining treatment and promoting recovery ( Li et al, 2017b ).…”

“…Model fit was assessed using various fit indices, including the chi-square (χ2) test of model fit, root mean square error of approximation (RMSEA), comparative fit index (CFI), goodness of fit (GFI), normed fit index (NFI) and Tucker-Lewis index (TLI). Indices were assessed using the following guidelines: 1 < χ2 /df < 3; RMSEA <0.08; GFI, CFI, NFI and TLI > 0.90 ( Bu et al, 2023 ). The model fitting results were that χ 2 /df = 2.480, GFI = 0.972, RMSEA = 0.064, NFI = 0.992, CFI = 0.995, and TLI = 0.991, indicating that the fitting degree of the model was good (6) ( Table 5 ).…”

“…Self-disclosure can help individuals rebuild positive social sharing beliefs ( Tajvar et al, 2018 ; Levi-Belz and Hamdan, 2023 ). Social support influences the self-disclosure of individuals ( Bu et al, 2023 ; Ricciardi et al, 2023 ); adequate social support helps individuals maintain a favorable emotional experience and increase self-confidence. Although a certain correlation may exist between self-disclosure, social support, and demoralization, the relationship and mechanism of action of the three variables have not been reported before.…”

Development and Psychometric Validation of the Breast Cancer Stigma Assessment Scale for Women with Breast Cancer and Its Survivors

“…Studies reveal that there are numerous sociodemographic variables, including the disease itself and its treatments, along with psychosocial variables that are related to stigma, causing suffering and related both to the conditions inherent to the disease experience and to the recovery of these women. Health professionals should pay attention to the assessment of stigma in order to respond to the needs of patients and survivors, as well as to develop better strategies for breast cancer health promotion and prevention [36][37][38][39][40][41][42][43][44].…”

A Discourse of Deviance: Blame, Shame, Stigma and the Social Construction of Head and Neck Cancer

“…Studies exploring the effects of other cancers with obvious physical changes (e.g., breast cancer) indicate that physical alterations such as a mastectomy and hair loss from chemotherapy are confronting changes that influence women’s quality of life (QoL) (Bu et al, 2023) and sense of self and are leveraged by the media to create fear (Lantz & Booth, 1998; Thorne & Murray, 2000). Further to this, people with cancer and their carers can experience a disgust response in relation to many cancer-related phenomena including surgical disfigurement, in cancers such as head and neck cancer (HNC) and sarcoma, the presence of a stoma in bowel cancer, and artificial feeding techniques (Azlan et al, 2017a; Powell et al, 2015).…”