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Aim <p>To establish a chain mediating model examining family caring, illness acceptance, perceived control, and self-perceived burden, based on the middle-range theory of adaptation to chronic illness, and to empirically test this model.</p> Methods <p>From June 2023 and March 2024, 254 elderly breast cancer patients were enrolled. Data were collected using a general information questionnaire, the family APGAR questionnaire, the self-perceived burden scale for breast cancer patients, the acceptance of illness scale, and the cancer experience and efficacy scale. IBM SPSS v26.0 and IBM AMOS v26.0 were used for data analysis.</p> Results <p>Family caring, illness acceptance, and perceived control demonstrated direct and statistically significant associations with self-perceived burden. Family caring indirectly affected self-perceived burden through five identified pathways. Three served as independent partial mediators in the relationship between family caring and self-perceived burden: illness acceptance (β = -0.172, [-0.110, -0.042]), perceived control (cancer experience) (β = -0.115, [-0.183, -0.056]), and perceived control (control efficacy) (β = -0.136, [-0.182, -0.098]). Two others were serial mediation pathways in the relationship: one through illness acceptance and perceived control (cancer experience) (β = 0.046, [0.016, 0.088]), and another through illness acceptance and perceived control (control efficacy) (β = 0.029, [0.013, 0.052]).</p> Conclusions and Implications for Cancer Survivors <p>The study confirmed that family caring primarily alleviates self-perceived burden by enhancing illness acceptance and reducing negative cancer-related experiences in elderly breast cancer patients. Thus, the assessment of family caring should be integrated into routine nursing practice, and psychoeducational programs designed to promote illness acceptance and reduce negative cancer-related experiences should be implemented.</p>

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Chain-mediating effect of illness acceptance and perceived control on the relationship between family caring and self-perceived burden in elderly patients with breast cancer: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月1日

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  • Yingjie Cai,
  • Qi Zhang,
  • Mi Li,
  • Harue Masaki,
  • Tieying Shi

摘要

Aim

To establish a chain mediating model examining family caring, illness acceptance, perceived control, and self-perceived burden, based on the middle-range theory of adaptation to chronic illness, and to empirically test this model.

Methods

From June 2023 and March 2024, 254 elderly breast cancer patients were enrolled. Data were collected using a general information questionnaire, the family APGAR questionnaire, the self-perceived burden scale for breast cancer patients, the acceptance of illness scale, and the cancer experience and efficacy scale. IBM SPSS v26.0 and IBM AMOS v26.0 were used for data analysis.

Results

Family caring, illness acceptance, and perceived control demonstrated direct and statistically significant associations with self-perceived burden. Family caring indirectly affected self-perceived burden through five identified pathways. Three served as independent partial mediators in the relationship between family caring and self-perceived burden: illness acceptance (β = -0.172, [-0.110, -0.042]), perceived control (cancer experience) (β = -0.115, [-0.183, -0.056]), and perceived control (control efficacy) (β = -0.136, [-0.182, -0.098]). Two others were serial mediation pathways in the relationship: one through illness acceptance and perceived control (cancer experience) (β = 0.046, [0.016, 0.088]), and another through illness acceptance and perceived control (control efficacy) (β = 0.029, [0.013, 0.052]).

Conclusions and Implications for Cancer Survivors

The study confirmed that family caring primarily alleviates self-perceived burden by enhancing illness acceptance and reducing negative cancer-related experiences in elderly breast cancer patients. Thus, the assessment of family caring should be integrated into routine nursing practice, and psychoeducational programs designed to promote illness acceptance and reduce negative cancer-related experiences should be implemented.