Influence of psychosocial adaptation on existential distress among young breast cancer survivors in the rehabilitation period: An analysis of the chain mediating effects of social support and psychological resilience.

Abstract

This study investigated the influence of psychosocial adaptation on existential distress among young breast cancer survivors during the rehabilitation period, with a focus on the chain-mediating roles of social support and psychological resilience. A cross-sectional survey was conducted with 390 young Chinese breast cancer survivors (aged 18-49 years, within 5 years post-treatment) recruited from tertiary hospitals. Participants completed standardized measures assessing psychosocial adaptation (PAIS-SR), social support (PSSS), psychological resilience (CD-RISC10), and existential distress (DS-II). Results from correlation analysis revealed that poorer psychosocial adaptation was significantly associated with higher existential distress (r = 0.510), lower social support (r = -0.306), and reduced psychological resilience (r = -0.412). Structural equation modeling demonstrated a significant direct effect of psychosocial adaptation on existential distress (effect = 0.514). Crucially, mediation analysis using bootstrapping confirmed three significant indirect pathways: the independent mediation of social support (effect = 0.061, 51.3%), the independent mediation of psychological resilience (effect = 0.040, 33.6%), and their sequential chain mediation (effect = 0.018,15.1%). The findings indicate that social support and psychological resilience function as both independent and sequential protective factors, mitigating the impact of psychosocial adaptation challenges on existential distress. The study underscores the importance of integrated interventions that enhance external support systems and foster internal resilience to improve psychological outcomes for young breast cancer survivors navigating the unique challenges of the rehabilitation phase.