The mediating role of self-advocacy in family cohesion and adaptability and health promotion in breast cancer survivors

Abstract

Background: Breast cancer is the most common cancer among women. Health-promoting behaviors can enhance the quality of life for breast cancer survivors; however, further research is needed to identify the factors influencing these behaviors.

Methods: A survey was conducted on 238 breast cancer survivors from a tertiary hospital in Chongqing using a general information questionnaire, the Family Cohesion and Adaptability Scale, the Self-Advocacy Scale, and the Health-Promoting Lifestyle Profile II. Descriptive analysis was performed using SPSS 26.0, and the mediating effect of variables was analyzed using the structural equation model in SPSS AMOS 24.0.

Results: The model results revealed positive correlations between family cohesion and adaptability and self-advocacy (β = 0.55; p < 0.05), between family cohesion and adaptability and health promotion (β = 0.42; p < 0.05), and between self-advocacy and health promotion (β = 0.43; p < 0.05) among breast cancer survivors. Furthermore, self-advocacy partially mediated the relationship between family cohesion and adaptability and health-promoting lifestyles (β = 0.237; p < 0.05).

Conclusion: Self-advocacy is a mediator variable in the relationship between family cohesion and adaptability, and the health-promoting lifestyle of breast cancer survivors.

Keywords: breast cancer; family cohesion and adaptability; health promotion; mediating effect; self-advocacy.

Figure 1

Standardized estimates of the relationships and effect sizes in the structural model. Family: Family Adaptability and Cohesion; Decision, Informed decision-making; Communication, Effective communication; Connected, Connected strength.