Structural Equation Modeling of the Mediating Role of Loneliness in the Relationship between Perceived Social Support and Self-Compassion with Prolonged Grief Disorder in Breast Cancer survivors
Subject Areas : Modeling research studies
Zeynab Jafari Hannan
1
,
Mohammad Reza Tamannaeifar
2
1 - M.A Student in Psychology, Department of Psychology, Institute of Allameh Feyz Kashani, Kashan, Iran
2 - (Corresponding author), Associate Professor, Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran, tamannai@kashanu.ac.ir Tel: 09131616609
Keywords: breast cancer, loneliness, perceived social support, prolonged grief disorder, self-compassion, structural equation modeling, survivors,
Abstract :
Abstract Introduction: The purpose of the present study was to investigate structural equation modeling of the mediating role of loneliness in the relationship between perceived social support and self-compassion with prolonged grief disorder in breast cancer survivors. Methods: This was descriptive-correlation research. The statistical population of the study was breast cancer survivors (children and spouse) of Qom city in spring of year 2024. The sample size was selected based on Klein's model and with subjectivw sampling of 300 people. Data collection tools include the prolonged grief ‐13‐revised (PG‐13‐R) scale of Prigerson and et al, multidimensional perceived social support scale (MSPSS) of Zimet and et al (1988), self- compassion scale (SCS) of Neff and University of California, Los Angeles- loneliness scale, version 3 (UCLA LS3) of Russell. Data were analyzed using Pearson correlation and structural equations modeling. Results: The results showed direct effect of perceived social support (β= -0.77 and sig=0.001) and self-compassion (β= -0.47 and sig=0.001) were significant on prolonged grief disorder. Also, the results showed that theory of mind had a mediating role in relationship between perceived social support (β= -0.65 and sig=0.001) and self-compassion (β= -0.62 and sig=0.001) with prolonged grief disorder. Also, the final research model had a good fit (RMSEA=0.06, p<0.05). Conclusion: According to the findings of this research and the importance of the role of perceived social support and self-compassion in prolonged grief disorder, psychologists are suggested to use social support training and interventions based on self-compassion to reduce the prolonged grief disorder in breast cancer survivors.
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1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021; 71(3): 209-49. https://doi.org/10.3322/caac.21660
2. Abachizadeh K, Moradi-Kouchi A, Ghanbari-Motlagh A, Kousha A, Shekarriz-Foumani R, Erfani A. Breast cancer in Iran: Levels, variations and correlates. Community Health (Salamat ijtimai). 2018; 5(1): 11-21. https://journals.sbmu.ac.ir/ch/index.php/ch/article/view/15856/14461
3. Whelan TJ, Smith S, Parpia S, Fyles AW, Bane A, Liu FF, Levine MN. Omitting radiotherapy after breast-conserving surgery in luminal a breast cancer. New England Journal of Medicine, 2023; 389 (7): 612-619. https://doi.org/10.1056/NEJMoa2302344
4. Yue L, Luo Y, Jiang L, Sekido Y, Toyokuni S. PCBP2 knockdown promotes ferroptosis in malignant mesothelioma. Pathology International, 2022; 72 (4): 242-251. https://doi.org/10.1111/pin.13209
5. Jefford M, Howell D, Li Q, Lisy K, Maher J, Alfano CM, Emery J. Improved models of care for cancer survivors. The Lancet, 2022; 399(10334): 1551-1560. https://doi.org/10.1016/s0140-6736(22)00306-3
6. Kaiser J, Treml J, Hoffmann R, Linde K, Nagl M, Kersting A. Factors associated with treatment response in an internet-based intervention for prolonged grief disorder after cancer bereavement. Behavior Therapy, 2023; 54(1): 119-131. https://doi.org/10.1016/j.beth.2022.07.008
7. Goveas JS, O'Connor MF. Prolonged grief disorder: unveiling neurobiological mechanisms for a shared path forward. The American Journal of Geriatric Psychiatry, 2024; 32(5): 535-538. https://doi.org/10.1016/j.jagp.2023.12.016
8. Cerel J, Brown MM, Maple M, Singleton M, Van de Venne J, Moore M, Flaherty C. How many people are exposed to suicide? Not six. Suicide and Life‐Threatening Behavior, 2019; 49(2): 529-534. https://doi.org/10.1111/sltb.12450
9. Verdery AM, Smith-Greenaway E, Margolis R, Daw J. Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. Proceedings of the National Academy of Sciences, 2020; 117(30): 17695-17701. https://doi.org/10.1073/pnas.2007476117
10. Yuan MD, Liu JF, Zhong BL. Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China: a systematic review and meta-analysis. General Psychiatry, 2024; 37(2): 1-10. https://doi.org/10.1136%2Fgpsych-2023-101216
11. Aeschlimann A, Gordillo N, Ueno T, Maercker A, Killikelly C. Feasibility and Acceptability of a mobile app for prolonged grief disorder symptoms. Clinical Psychology in Europe, 2024; 6(1): 1-23. http://dx.doi.org/10.32872/cpe.10881
12. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition, text revision. Washington: American Psychiatric Association. 2022. https://www.psychiatry.org/psychiatrists/practice/dsm
13. Wen FH, Prigerson HG, Chou WC, Huang CC, Hu TH, Chiang MC, Tang ST. How symptoms of prolonged grief disorder, posttraumatic stress disorder, and depression relate to each other for grieving ICU families during the first two years of bereavement. Critical Care, 2022; 26(1): 336-347. https://doi.org/10.1186/s13054-022-04216-5
14. Lechner-Meichsner F, Comtesse H, Olk M. Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review. Conflict and Health, 2024; 18(1): 32-52. https://doi.org/10.1186/s13031-024-00586-5
15. Eisma MC. Prolonged grief disorder in ICD-11 and DSM-5-TR: Challenges and controversies. Australian & New Zealand Journal of Psychiatry, 2023; 57(7): 944-951. https://doi.org/10.1177/00048674231154206
16. Kustanti CY, Chu H, Kang XL, Huang TW, Jen HJ, Liu D, Chou KR. Prevalence of grief disorders in bereaved families of cancer patients: A meta-analysis. Palliative Medicine, 2022; 36(2): 305-318. https://doi.org/10.1177/02692163211066747
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