School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The College at Brockport, State University of New York, Brockport, New York, USA.
Psychooncology. 2021 Mar;30(3):392-399. doi: 10.1002/pon.5590. Epub 2020 Nov 27.
Despite the increasing scholarly attention toward self-stigma among Asian breast cancer survivors, research is limited about the underlying psychological mechanisms by which self-stigma may influence quality of life for this population. The present study investigated how self-stigma is associated with quality of life among Chinese American breast cancer survivors by examining the serial mediating effects of concerns about breast cancer, self-efficacy for coping with cancer, and depressive symptoms.
Chinese American breast cancer survivors (n = 112) completed a questionnaire packet assessing self-stigma related to breast cancer, concerns about breast cancer, self-efficacy for coping with cancer, depressive symptoms, and quality of life. Path analysis was conducted to test the hypothesized serial multiple mediation model.
The hypothesized model was supported: self-stigma was negatively associated with quality of life through concerns about breast cancer, self-efficacy, and depressive symptoms. After the mediators were controlled for, the direct effect of self-stigma on quality of life was no longer significant.
Our findings suggest that concerns about breast cancer, self-efficacy for coping, and depressive symptoms are important pathways through which self-stigma may influence quality of life among Chinese American breast cancer survivors. Healthcare practitioners should be aware of survivors' self-stigma and make efforts to alleviate survivors' excessive cancer concerns, facilitate their self-efficacy, and offer emotional support to improve quality of life for this population.
尽管越来越多的学者关注亚洲乳腺癌幸存者的自我污名化,但关于自我污名如何影响这一人群生活质量的潜在心理机制的研究还很有限。本研究通过考察对乳腺癌的担忧、应对癌症的自我效能感和抑郁症状的序列中介效应,探讨了自我污名化与华裔美国乳腺癌幸存者生活质量之间的关系。
华裔美国乳腺癌幸存者(n=112)完成了一份问卷,评估与乳腺癌相关的自我污名、对乳腺癌的担忧、应对癌症的自我效能感、抑郁症状和生活质量。采用路径分析检验假设的序列多重中介模型。
假设模型得到支持:自我污名与生活质量呈负相关,通过对乳腺癌的担忧、自我效能感和抑郁症状。在控制了中介变量后,自我污名对生活质量的直接影响不再显著。
我们的研究结果表明,对乳腺癌的担忧、应对癌症的自我效能感和抑郁症状是自我污名可能影响华裔美国乳腺癌幸存者生活质量的重要途径。医疗保健从业者应该意识到幸存者的自我污名,并努力减轻幸存者的过度癌症担忧,增强他们的自我效能感,并提供情感支持,以改善这一人群的生活质量。