Available online 17 November 2023, 151526

Author links open overlay panel, , , , , ABSTRACTObjectives

This investigation aims to explore relationships between adult attachment, emotional self-disclosure, and quality of life (QoL).

Data Sources

The study sample completed the Chinese versions of the Experiences in Close Relationships Inventory, the Functional Assessment of Cancer Therapy-Breast Scale, and the Distress Disclosure Index between October 2021 and March 2022. The relationships between adult attachment, emotional self-disclosure, and QoL were investigated using a multiple mediation effects test and structural equation modeling.

Conclusion

Attachment anxiety and avoidance were risk factors for young Chinese breast cancer survivors’ emotional self-disclosure and QoL. Emotional self-disclosure mediates the association between attachment anxiety or avoidance and QoL. Assessing and easing attachment anxiety and avoidance may improve the emotional self-disclosure and QoL of young breast cancer survivors.

Implications for Nursing Practice

This study confirms that adult attachment plays an important role in young breast cancer patients’ adaptation to the disease and that high adult anxiety and avoidance levels can significantly reduce emotional self-disclosure and QoL in young breast cancer survivors. Identifying attachment patterns can help caregivers better understand patients’ responses, adaptation, and treatment adherence to cancer, thereby helping caregivers develop targeted and personalized cancer care practice programs or psychotherapy interventions to improve patients’ physical and mental health outcomes.

Section snippetsBACKGROUND

In 2020, breast cancer accounted for 11.7% of all new malignant tumors worldwide, making it the most prevalent malignant tumor.1 In the past decade, its incidence in China increased by an average of 3% to 4% per year, and the trend in youth is significant.2,3 Younger breast cancer patients face a worse prognosis than those middle-aged or older. In particular, young patients with estrogen receptor (ER) luminal breast cancer face a 2.1-fold increased risk of death compared with patients aged

OBJECTIVES

This study aimed to describe the status of adult attachment, emotional self-disclosure, and QoL among young breast cancer survivors and explore the relationship between these three variables.

Design and Sample

This cross-sectional study was conducted in Sichuan Province in southwestern China. The convenience sampling method was adopted to select 11 tertiary grade A general hospitals as sample hospitals. All breast oncology patients in these sampled hospitals were included. Participants’ age limit was 39 years as proposed by the Adolescent and Young Adult Oncology Progress Review Group. The inclusion criteria were (1) female; (2) aged 18 to 39 years; (3) diagnosed with breast cancer within 1 year

Descriptive Statistics

The descriptive statistics for sociodemographic and clinical characteristics are presented in Table 1. Regarding age, 51.9% of the breast cancer survivors were between the ages of 25 and 34 years. Regarding educational background, the majority of patients indicated senior high school, followed by bachelor's or college degrees. The majority were married, more than half had children, and 43.5% were unemployed. The number of households with per capita monthly income of less than 450 USD was the

DISCUSSION

This study aimed to investigate the relationship between adult attachment, emotional self-disclosure, and QoL and explored the mediating role of emotional self-disclosure between adult attachment and QoL in young Chinese breast cancer survivors. As hypothesized, higher attachment anxiety was associated with lower emotional self-disclosure and QoL. Additionally, the hypothesis that attachment avoidance is linked to reduced emotional self-disclosure and QoL was supported. Finally, emotional

CONCLUSION

Attachment anxiety and avoidance were risk factors for emotional self-disclosure and QoL among young Chinese breast cancer survivors. Furthermore, emotional self-disclosure mediates the association between attachment anxiety or avoidance and QoL. Assessing and easing attachment anxiety and avoidance may improve the emotional self-disclosure and QoL of young breast cancer survivors. Young breast cancer survivors should be provided with interventions that emphasize emotional self-disclosure based

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Author Contributions

Lin Tao provided conceptualization, methodology, writing—original draft, data curation, software, writing—review and editing; Jieying Lv provided conceptualization, methodology, writing—original draft; Xueling Tan provided conceptualization, methodology, writing—original draft; Xiaoxia Hu provided data curation, software, writing—review and editing; Lan Fu provided validation, supervision; and Junying Li provided data curation, software, writing—review and editing, validation, supervision.

Ethics Approval

The Clinical Trial and Biomedical Ethics Committee of West China Hospital, Sichuan University (No. 2021(1442)) approved the data collection procedures that involved the study participants to ensure that they are conducted in accordance with the ethical standards.

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