The effects of family resilience and body image on psychosocial adaptation among young and middle-aged breast cancer patients

Aim To determine how family resilience and body image are related to psychosocial adaptation in young and middle-aged patients with breast cancer and whether body image functions as a mediator. Background Social support is known to be relevant to adaptation after breast cancer. Less is known about the pathway linking family resilience to psychosocial adaptation through body image. Methods Questionnaire data were obtained from 229 postoperative patients selected by convenience sampling. Family resilience, body image, and psychosocial adaptation were measured using the Chinese versions of the Family Resilience Scale, Body Image Scale, and Psychosocial Adaptation Scale for Breast Cancer, respectively. The hypothesized associations and indirect pathway were evaluated by structural equation modeling. Results Valid data were available for 220 of the 229 participants (96.07%). Family resilience, body image, and psychosocial adaptation had mean scores of 102.34 ± 12.93, 7.19 ± 5.91, and 181.10 ± 27.97, respectively. Family resilience was negatively correlated with body image ( r = −0.292, P < 0.01) and positively correlated with psychosocial adaptation (r = 0.480, P < 0.01). Of the total association between family resilience and psychosocial adaptation, 67.58% was attributable to the direct pathway and 32.42% to the indirect pathway through body image. Conclusion Patients reporting stronger family resilience also showed better psychosocial adaptation. Part of this association operated through body image. Interventions addressing both family resilience and body image may be useful for young and middle-aged patients with breast cancer. Relevance to clinical practice Assessment of psychosocial adaptation should consider both the patient's family environment and concerns about physical appearance. Family-based support may assist patients in managing body image distress and adapting to life after breast cancer treatment.