Coping style as mediator between resilience, perceived social support, and health-related quality of life in Chinese mainland women newly diagnosed with breast cancer

Abstract

Background Breast cancer may impair health-related quality of life (HRQoL). We examined the mediating role of coping style (CS) in the relationship between resilience, perceived social support (PSS), and HRQoL in newly diagnosed breast cancer patients in the Chinese mainland. Methods A total of 431 patients completed a survey at two hospitals in Shaanxi Province, China, using self-report measures assessing HRQoL, resilience, PSS, and CS. A one-sample t-test analyzed differences between resilience, PSS, and CS in breast cancer patients and the corresponding norm. Multivariate linear regression analyzed the independent predictors of HRQoL. The mediating role of CS between resilience, PSS, and HRQoL were investigated using structural equation modeling (SEM). Results Participants had significantly lower scores for resilience and PSS and higher scores for the avoidance and resignation CSs than their corresponding norm. SEM analysis showed resilience had significant direct effects on CS (B:0.66, 95% CI: 0.54, 0.77) and HRQoL [0.32 (0.12, 0.49)]. PSS had significant direct effects on CS [0.18 (0.06, 0.29)]. Resilience [0.32 (0.19, 0.53)] and PSS [0.09 (0.03, 0.18)] had significant indirect effects, and resilience [0.64 (0.56, 0.71)] had significant total effects on HRQoL. CS had significant direct and total effects on HRQoL [0.48 (0.30, 0.72)]. Conclusions Newly diagnosed breast cancer patients of mainland China had lower resilience and PSS and higher negative CSs. CS appeared to mediate the influence of resilience and PSS on HRQoL. Multimodal intervention programs focusing on CS might increase the influence of resilience and PSS on HRQoL in breast cancer patients.