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Mediating the role of medical coping styles among psychosocial factors in breast cancer patients with type C personality
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  • Published: 04 February 2026

Mediating the role of medical coping styles among psychosocial factors in breast cancer patients with type C personality

  • Xiao-Ying Shen1 na1,
  • Jun Wang1 na1,
  • Li-li Qiu1,
  • Yan-Ni Wu1,
  • Yan Cui1,
  • Run-Na Miao2 na2 &
  • …
  • Chang-ying Yu1 na2 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Cancer
  • Oncology

Abstract

Previous studies have shown that the hope of breast cancer patients is related to the social relational quality, and personality is related to acceptance of disability. However, research is still unclear about the underlying potential psychological mechanisms of various psycho-social factors for this population. This study aims to investigate the impact of breast cancer patients’ hope and type C personality on social relational quality and acceptance of disability, and to evaluate the mediating the role of medical coping styles. A total of 141 breast cancer patients during chemotherapy were recruited from Harbin, China completed a self-reported questionnaire containing the personal information questionnaire, Herth hope index (HHI), Type C behavior scale, Medical coping modes questionnaire (MCMQ), Social relationship quality scale (SRQS) and Acceptance of disability scale (ADS). Results showed that the proposed model fitted the data very well (χ2 = 8.357, df = 7, p = 0.302, χ2/df = 1.194, GFI = 0.981, CFI = 0.991, TLI = 0.982, RMSEA = 0.037). Further analyses revealed that, confrontation mediated the relationship between hope and social relational quality (indirect effect = 0.025, BC 95%CI = 0.001, 0.079), and acceptance-resignation mediated the relationship between type C personality and acceptance of disability (indirect effect = − 0.109, BC 95%CI = − 0.188, − 0.044). Confrontation and acceptance-resignation played critical roles in the relationship between hope, type C personality and social relational quality, the acceptance of disability of breast cancer patients. Healthcare practitioners should be aware of the coping strategies of breast cancer patients, and psycho-social interventions and supportive care should focus on these cognitive and emotional processes to improve social relational quality and acceptance of disability for this population.

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Data availability

As the research data are still required for subsequent experiments, the original datasets are not currently available.They can be obtained upon reasonable request from the first author. Please contact [Xiao-Ying Shen] at [Wy1301831398@163.com].

References

  1. Bray, F. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 74, 229–263 (2024).

    Google Scholar 

  2. Sung, H. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 71, 209–249 (2021).

    Google Scholar 

  3. Li, P., Li, H., Zhang, J. & Yang, J. Symptom clusters and their correlation with quality of life in breast cancer patients during dual-targeted therapy. J. Nurs. Sci. 2023, 38–42 (in Chinese).

  4. Shen, X. Y. et al. Type C behavior and associated factors in patients with breast cancer during postoperative chemotherapy: A cross-sectional study. Psychol. Res. Behav. Manag. 14, 1281–1289 (2021).

    Google Scholar 

  5. Gutiérrez-Hermoso, L. et al. The effect of treatment and coping on the quality of life in breast cancer patients: A moderated mediation model. Qual. Life Res. 31, 147–158 (2022).

    Google Scholar 

  6. Zhang, Q. et al. Psychosocial predictors of adjustment to disability among patients with breast cancer: A cross-sectional descriptive study. J. Nurs. Res. 27, e15 (2019).

    Google Scholar 

  7. Zahid, N. et al. Psychosocial factors influencing quality of life in patients with primary brain tumors in Pakistan: An analytical cross-sectional study. BMC Res. Notes 16, 89 (2023).

    Google Scholar 

  8. Peng, M., Zhang, Y. P., Wu, Y. & Li, R. Emotional health in cancer patients: The role of social media and emotional support based on structural equation modeling. Support Care Cancer 31, 417 (2023).

    Google Scholar 

  9. Hou, W. K., Lam, W. W. T., Law, C. C., Fu, Y. T. & Fielding, R. Measuring social relational quality in colorectal cancer: The social relational quality scale (SRQS). Psycho-Oncol. 18, 1097–1105 (2009).

    Google Scholar 

  10. Hou, W. K., Lam, W. W. & Fielding, R. Adaptation process and psychosocial resources of Chinese colorectal cancer patients undergoing adjuvant treatment: A qualitative analysis. Psychooncology 18, 936–944 (2009).

    Google Scholar 

  11. Rustøen, T., Lerdal, A., Gay, C. & Kottorp, A. Rasch analysis of the Herth Hope Index in cancer patients. Health Qual. Life Outcomes 16, 196 (2018).

    Google Scholar 

  12. Xiong, M. et al. Attributes and influencing factors of hope levels in breast cancer patients: A latent profile analysis. Br. J. Health Psychol. 30, e12773 (2025).

    Google Scholar 

  13. Qin, J., Zhang, Q., Li, X. & Feng, L. Postoperative early social relationship quality and hope level in breast cancer patients: Current status and correlation. Xian Dai Lin Chuang Hu Li 2017, 10–13 (in Chinese).

  14. Zeng, Y. et al. Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer. Nat. Med. 30, 1680–1688 (2024).

    Google Scholar 

  15. Eskelinen, M. & Ollonen, P. Cancer-prone personality characteristics in healthy subjects and breast disease patients. Anticancer Res. 31, 4013–4017 (2011).

    Google Scholar 

  16. Guo, L. et al. Research progress of the correlation between C-type personality and malignant tumor. Mod. Prev. Med. 46, 1524–1527 (2019) ((in Chinese)).

    Google Scholar 

  17. Wei, M. et al. Type C personality and depression among newly diagnosed breast cancer patients: The mediating role of sense of coherence. Neuropsychiatr. Dis. Treat. 15, 3519–3529 (2019).

    Google Scholar 

  18. Montañés-Muro, P., Martínez-Tomé, M. & García-Manzano, G. Psychosocial care needs of women with breast cancer: Body image, self-esteem, optimism, and sexual performance and satisfaction. Health Soc. Work 48, 115–123 (2023).

    Google Scholar 

  19. Lima, M. P., Moret-Tatay, C. & Irigaray, T. Q. Locus of control, personality and depression symptoms in cancer: A moderated mediation model. Clin. Psychol. Psychother. 29, 489–500 (2022).

    Google Scholar 

  20. Zhou, C., Wang, Y., Li, W., Xue, L. & Zhou, X. Relationship between personality traits and chemotherapy-related symptoms in breast cancer. Chin. Nurs. Res. 2016, 1812–1815 (in Chinese).

  21. Gillis, C. et al. Personality traits and urinary symptoms are associated with mental health distress in patients with a diagnosis of prostate cancer. Curr. Oncol. 28, 2993–3002 (2021).

    Google Scholar 

  22. Wang, X., Wang, P., Guan, Q. & Zhang, J. C-type behavioral characteristics in gastric cancer patients and correlations with immune markers. Chin. J. Cell Mol. Immunol. 6, 615–619 (2008) ((in Chinese)).

    Google Scholar 

  23. Dunn, D. S. & Elliott, T. R. Revisiting a constructive classic: Wright’s Physical Disability: A Psychosocial Approach. Rehabil. Psychol. 50, 183–189 (2005).

    Google Scholar 

  24. Zhou, Q. et al. Relationship between neurotic personality traits with symptoms of post-traumatic stress disorder in breast cancer patients: With the mediation of self-efficacy and negative coping. BMC Psychol. 13, 282 (2025).

    Google Scholar 

  25. Huang, Z. & Wu, S. Correction to: Acceptance of disability, coping style, social support and quality of life among lymphedema patients. Support Care Cancer 30, 4109 (2022).

    Google Scholar 

  26. Lin, L., Yang, Y., Zhang, J., Qi, X., Wang, L., Wang, Y. & Ren, L. Mediating effect of resignation coping mode between fear of cancer recurrence and hope level in triple negative breast cancer patients. Chin. J. Breast Dis. (Electron. Ed.) 19, 226–231 (2025) (in Chinese).

  27. Folkman, S., Lazarus, R. S., Gruen, R. J. & Delongis, A. Appraisal, coping, health status and psychological symptoms. J. Pers. Soc. Psychol. 50, 571–579 (1986).

    Google Scholar 

  28. Kendall, M. Multivariate Analysis. 123–131 (1975).

  29. Hou, J. T., Wen, Z. L. & Cheng, Z. J. Structural Equation Model and Its Application (Educational Science Press, 2004) ((in Chinese)).

    Google Scholar 

  30. Herth, K. Abbreviated instrument to measure hope: Development and psychometric evaluation. J. Adv. Nurs. 17, 1251–1259 (1992).

    Google Scholar 

  31. Jian, Z. & Wang, J. Social support and hope in hemodialysis patients. Chin. J. Mod. Nurs. 2000, 49–51 (in Chinese).

  32. Yan, H. How TCM Comprehensive Therapy Affects Quality of Life in Postoperative Breast Cancer Patients. PhD Thesis, Nanjing Univ. Tradit. Chin. Med. (2017) (in Chinese).

  33. Feifel, H., Strack, S. & Nagy, V. T. Degree of life threat and differential use of coping modes. J. Psychosom. Res. 31, 91–99 (1987).

    Google Scholar 

  34. Shen, X. & Jiang, Q. Application of the Chinese version of MCMQ in 701 patients. Chin. Behav. Med. Sci. 2000, 22–24 (in Chinese).

  35. Chen, N., Yuan, C. & Shun, X. Relationship between acceptance of disability and PTSD in brachial plexus injury. Chin. J. Nurs. 44, 677–680 (2009) ((in Chinese)).

    Google Scholar 

  36. Hu, L. T. & Bentler, P. M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria vs. new alternatives. Struct. Equ. Modeling 6, 1–55 (1999).

    Google Scholar 

  37. Zhang, J., Gao, W., Wang, P. & Wu, Z. Relationships among hope, coping style and social support for breast cancer patients. Chin. Med. J. 123, 2331–2335 (2010).

    Google Scholar 

  38. Wu, Z., Liu, Y., Li, X. & Li, X. Resilience among newly diagnosed Chinese women with breast cancer. PLoS ONE 11, e0167976 (2016).

    Google Scholar 

  39. Xiong, M. et al. The impact of fear of cancer recurrence on the quality of life of breast cancer patients: A longitudinal study of the mediation effect of cortisol and hope. Eur. J. Oncol. Nurs. 70, 102600 (2024).

    Google Scholar 

  40. Cui, M. et al. Enhancing symptom control in postoperative middle-aged breast cancer patients through family support: A cross-sectional study utilizing latent profile analysis and latent interaction models. Eur. J. Oncol. Nurs. 78, 102944 (2025).

    Google Scholar 

  41. Lamore, K., Giardinelli, A. M. & Wawrziczny, É. Factors contributing to sexual dissatisfaction in women with breast cancer. Eur. J. Oncol. Nurs. 76, 102866 (2025).

    Google Scholar 

  42. Casuso-Holgado, M. J. et al. Exercise interventions for self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer: A systematic review with meta-analysis and meta-regressions. Support. Care Cancer 32, 665 (2024).

    Google Scholar 

  43. Tang, X. Y., Wei, Y. X., Kong, L. N. & Lu, F. Social support and self-care ability in breast cancer: Mediating roles of resilience and depression. J. Clin. Nurs. 34, 161–170 (2025).

    Google Scholar 

  44. Niu, J., Yang, K., Wang, J. & Li, H. Type C behavior, psychological resilience and benefit finding after breast cancer surgery. Chin. Nurs. Res. 34, 3606–3610 (2020) ((in Chinese)).

    Google Scholar 

  45. Li, J. H. Social Anxiety and Acceptance of Disability in Breast Cancer after Radical Surgery. MSc Thesis, North China Univ. Sci. Technol. (2018) (in Chinese).

  46. Xiao, S., Sun, L., Zhang, Q. & Wang, Q. Factors influencing acceptance of disability in postoperative breast cancer. J. Nurs. Admin. 17, 335–337 (2017) ((in Chinese)).

    Google Scholar 

  47. Lin, Z. & Zheng, G. Relationship between disability acceptance and quality of life in postoperative breast cancer patients. Modern Nurse 27, 22–25 (2020) ((in Chinese)).

    Google Scholar 

  48. Champagne, A. L. et al. Personality disorders, but not cancer severity or treatment type, are risk factors for later generalised anxiety disorder and major depressive disorder in non-metastatic breast cancer patients. Psychiatry Res. 236, 64–70 (2016).

    Google Scholar 

  49. Zhu, M., Chen, M., Wu, M., Li, S. & Liao, Y. Acceptance of disability and discharge readiness in patients underwent modified radical mastectomy. Medicine 104, e44047 (2025).

    Google Scholar 

  50. Arefian, M. & Asgari-Mobarake, K. Mindfulness-integrated cognitive behavioral therapy reduces pain and psychological distress, and improves equanimity, hope and post-traumatic growth during breast cancer treatment: A pilot randomized controlled trial. Eur. J. Oncol. Nurs. 76, 102881 (2025).

    Google Scholar 

  51. Yang, X., Zhang, Y., Zhao, L. & Liang, X. Effect of health belief intervention on hope level and quality of life of breast cancer patients undergoing chemotherapy. Oncol. Prog. 21, 1269–1272 (2023) ((in Chinese)).

    Google Scholar 

  52. Guo, M. The application of emotional expression group psychological counseling for ovarian cancer patients in postoperative chemotherapy phase. MSc Thesis, Sichuan Univ. (2021) (in Chinese).

  53. Chen, Y. Effect of family members’ synchronous health education on psychological state, quality of life and family members’ Type C behavior in patients with cervical cancer after chemotherapy. Med. Forum 28, 124–127 (2024) ((in Chinese)).

    Google Scholar 

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Acknowledgements

The authors would like to thank all study participants and those who have contributed to this study

Funding

Social Sciences & Humanities Projects of Harbin Medical University, 023-KYYWF-0298.

Author information

Author notes
  1. Xiao-Ying Shen and Jun Wang have contributed equally to this study and share first authorship.

  2. Chang-ying Yu and Run-Na Miao have contributed equally to this study and share Corresponding author.

Authors and Affiliations

  1. Second Affiliated Hospital of Harbin Medical University, Harbin, China

    Xiao-Ying Shen, Jun Wang, Li-li Qiu, Yan-Ni Wu, Yan Cui & Chang-ying Yu

  2. Taishan Vocational College of Nursing, Tai’an, Shandong Province, China

    Run-Na Miao

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Contributions

Xiao-ying Shen123456, Jun Wang2345, Li–li Qiu135, Yan-Ni Wu125, Yan Cui256, Chang-ying Yu1256,Run-Na Miao1256. 1 Conceptualization; 2 Methodology; 3 Data curation; 4 Writing—Original Draft; 5 Writing—Review & Editing; 6 Funding acquisition.All authors reviewed the manuscript.

Corresponding authors

Correspondence to Run-Na Miao or Chang-ying Yu.

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The authors declare no competing interests.

Ethics approval and consent to participate

Ethical approval for this study was obtained from the Research Ethics Committee at Harbin Medical University (NO.KY2019-0118).And informed consent was obtained from the participants before starting the program.

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Cite this article

Shen, XY., Wang, J., Qiu, Ll. et al. Mediating the role of medical coping styles among psychosocial factors in breast cancer patients with type C personality. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35502-9

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  • Received: 04 May 2025

  • Accepted: 06 January 2026

  • Published: 04 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-35502-9

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Keywords

  • Acceptance of disability
  • Breast cancer
  • Coping
  • Hope
  • Social relationship quality
  • Type C personality
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