Abstract
Breast cancer and its treatment are particularly distressing for patients because of their potential impacts on body image. The most difficult phase of cancer treatment is usually the first year after a diagnosis. Cancer patients with strong resilience have the positive attitude, internal strength and external resources needed to cope with the disease and its treatment. This cross-sectional study investigated the mediator roles of hope and social support in the association between body image distress and resilience. A structured questionnaire was used to collect data for a convenience sample of 141 breast cancer patients undergoing treatment in southern Taiwan. Structural equation modeling was used for data analysis. The results showed that the final model had a good fit to the data and accounted for 51% of the total variance in resilience. The model of multiple parallel mediators of resilience revealed that hope and social support had mediator roles in the effect of body image distress on resilience. Hope had an important partial mediating role in the association between body image distress and resilience. Social support also had a partial mediating role in the relationship between body image distress and resilience. Social support did not directly affect resilience and indirectly affected resilience through hope. Psychosocial interventions aimed at reducing the impact of body image distress and increasing resilience in breast cancer patients should focus on cultivating hope and increasing social support, particularly support from family members and health professionals.
Highlights
Breast cancer is the most common cancer in women worldwide (Gradishar et al, 2020)
Breast cancer is rare in women younger than 25 years, but the incidence increases with age until age 50 years and plateaus at ages 50–69 years (Health Promotion Administration Ministry of Health Welfare, 2018)
The patients in this study generally revealed moderate scores for body image distress, hope, and social support and moderate-to-low scores for resilience
Summary
Breast cancer is the most common cancer in women worldwide (Gradishar et al, 2020). In Taiwan, the incidence of breast cancer in women exceeds that of all other cancer types (Hsu et al, 2017). Stage IV breast cancer is mainly treated with systemic therapy, including chemotherapy, hormone therapy, targeted therapy, immunotherapy or some combination of these (Gradishar et al, 2020) These treatments improve survival, breast cancer patients face many challenges during treatment, including the physical impacts of the disease, its treatment, and treatment side effects as well as psychological and social impacts of the cancer experience such as loss of hope and a sense of lost control over life (Hsu et al, 2017; Li et al, 2018). These experiences have strong associations with body image distress (Rezaei et al, 2016)
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