Investigating the mediating role of mental adjustment in the relationship between perceived stress and quality of life in patients with cancer.

Abstract

12106 Background: Cancer patients undergo a multifaceted journey fraught with substantial psychological distress and coping hurdles, profoundly influencing their overall well-being. The intricate nexus between perceived stress and diminished Health-Related Quality of Life (HRQoL) in this population has garnered significant attention. However, the pivotal role played by mental adjustment to cancer (MAC) as a potential mediator in this intricate relationship remains inadequately explored. Given the paramount importance of understanding the psychological dynamics inherent to cancer care, our study sought to delve into the mediating influence exerted by MAC on the association between perceived stress and HRQoL among individuals grappling with cancer. Methods: The study enrolled 214 cancer patients (74 male, 140 female, mean age = 50.57, SD= 13.07) from a University Teaching Hospital in South-West Nigeria. Participants completed assessments utilizing the Impact of Event Scale, Mental Adjustment to Cancer, and Health-Related Quality of Life (measured by the Functional Assessment of Cancer Therapy–General). The study utilized a cross-sectional design, and data analysis was performed using mediation analysis with PROCESS procedures in SPSS. Results: Results indicated that perceived stress was associated with lower HRQoL (β = -.71, p < .001, CI, -1.02, -.39). Among the five dimensions of MAC, three sub-dimensions: helplessness (β = -.49, p < .05, CI, -.95, -.02), anxious occupation (β = -1.45, p < .05, CI, -1.92, -.96) and cognitive avoidance (β = 1.43, p < .001, CI, .61 – 2.25) were significantly associated with HRQoL. Mediation analysis showed that only two dimensions—helplessness and anxious preoccupation —mediated the relationship between cancer-related stress and HRQoL. The indirect effect for both helplessness (β = -.14, SE = .069, CI -.24, -.01) and anxious preoccupation (β = -.31, SE = .09, CI -.51, -.15) were significant. The findings indicate that stress related to cancer may lead to elevated levels of helplessness and anxious preoccupation, subsequently contributing to a decrease in Health-Related Quality of Life (HRQoL). Conclusions: This study provides valuable insights into the intricate relationship between perceived stress, mental adjustment to cancer, and HRQoL, offering implications for targeted interventions aimed at enhancing the well-being of individuals grappling with the challenges of cancer diagnosis and treatment. By tailoring interventions to address these nuanced dynamics, healthcare providers can foster improved overall well-being and adaptive capacities in individuals navigating the complexities of cancer care. Key words: Cancer patients, mental adjustment to cancer, perceived stress, health-related quality of life