This study aims to investigate the individual differences in perceived controllability among women with gynecologic cancer who are undergoing chemotherapy. We also examined the mediating effect of symptom distress on the relationship between individual differences and perceived controllability. This cross-sectional study employs purposive sampling; data were collected via self-reported questionnaires. In total, 170 women completed the survey. Structural equation modeling was used to examine the proposed hypotheses of the mediating effect of symptom distress. Results revealed that individual differences in age (r=-0.20, p<.05), education (t=-2.24, p<.05), employment (t=-2.05, p<.05), cancer stage (t=2.35, p<.05), and number of chemotherapy sessions in the past three months (r=-0.16, p<.05) were significantly associated with perceived treatment control. Physical, but not psychological, symptom distress fully mediated the relationship between individual differences and perceived controllability. Participants who perceived financial distress (β=0.179, p<.05) and those who had undergone a higher number of chemotherapy sessions within the past three months (β=0.216, p<.05) experienced greater physical symptom distress. Additionally, those who experienced greater physical symptom distress perceived lower personal control (β=-0.199, p<.05) and treatment control (β=-0.217, p<.05). Understanding the mediating effects of symptom distress on the relationship between individual differences and perceived controllability can enhance our knowledge of the mechanisms of illness acceptance, which significantly contributes to illness adaptation among women with gynecologic cancer.
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