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JRUMS 2025, 24(4): 360-374 |
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Ethics code: IR.KASHANU.REC.1402.040
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Structural Equation Modeling of Resilience Based on Cognitive Emotion Regulation Strategies and Perceived Social Support with the Mediating Role of Self-Efficacy in Breast Cancer Patients: A Descriptive Study. JRUMS 2025; 24 (4) :360-374
URL: http://journal.rums.ac.ir/article-1-7664-en.html
URL: http://journal.rums.ac.ir/article-1-7664-en.html
Keywords: Resilience, Self-efficacy, Cognitive emotion regulation strategies, Perceived social support, Breast cancer
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Structural Equation Modeling of Resilience Based on Cognitive Emotion Regulation Strategies and Perceived Social Support with the Mediating Role of Self-Efficacy in Breast Cancer Patients: A Descriptive Study
Mohammad Reza Tamannaeifar[1], Zahra Suleimanian[2]
Received: 11/02/25 Sent for Revision: 01/03/25 Received Revised Manuscript: 18/05/25 Accepted: 18/05/25
Background and Objectives: Breast cancer is one of the most common cancers in women that have many effects on psychological health. The purpose of this research was to predict resilience based on cognitive emotion regulation strategies and perceived social support with the mediating role of self-efficacy in breast cancer patients.
Materials and Methods: The present study was descriptive and correlational. The statistical population consisted of all women with breast cancer who had an active case in the oncology departments of Imam Khomeini (RA) and Imam Hossein (AS) Hospitals in Tehran in 2023. Two-hundred and fifty individuals were selected using the convenience sampling method. Data collection tools included the Cognitive Emotion Regulation Questionnaire (CERQ) by Garnefski et al. (2001), the Resilience Scale (RISC) by Connor and Davidson (2003), the Perceived Social Support Scale (MSPSS) by Zimet et al. (1988), and the General Self-Efficacy Scale (GSES) by Scherer et al. (1982). The Pearson’s correlation coefficient and structural equation modeling were used for the statistical analysis of the data.
Results: The findings showed that maladaptive cognitive emotion regulation (β=-0.26, p=0.002), adaptive cognitive emotion regulation (β=0.39, p=0.001), perceived social support (β=0.22, p=0.001), and self-efficacy (β=0.29, p=0.001) have a direct and significant effect on resilience. Cognitive emotion regulation strategies and perceived social support, with the mediation of self-efficacy, explain a total of 43% of the variance in resilience. Additionally, the final research model demonstrated a good fit.
Conclusion: Given the mediating role of self-efficacy in the relationship between cognitive emotion regulation strategies and perceived social support with resilience in women with breast cancer, it is recommended that targeted interventions be implemented to enhance resilience by improving emotion regulation, increasing social support, and strengthening self-efficacy, thereby supporting the mental health of these patients.
Keywords: Resilience, Self-efficacy, Cognitive emotion regulation strategies, Perceived social support, Breast cancer
Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of University of Kashan approved the study (IR.KASHANU.REC.1402.040).
Authors’ contributions:
- Conceptualization: Mohammad Reza Tamannaeifar
- Methodology: Mohammad Reza Tamannaeifar
- Data collection: Zahra Suleimanian
- Formal analysis: Zahra Suleimanian
- Supervision: Mohammad Reza Tamannaeifar
- Project administration: Mohammad Reza Tamannaeifar
- Writing – original draft: Mohammad Reza Tamannaeifar, Zahra Suleimanian
- Writing – review & editing: Mohammad Reza Tamannaeifar, Zahra Suleimanian
Mohammad Reza Tamannaeifar[1], Zahra Suleimanian[2]
Received: 11/02/25 Sent for Revision: 01/03/25 Received Revised Manuscript: 18/05/25 Accepted: 18/05/25
Background and Objectives: Breast cancer is one of the most common cancers in women that have many effects on psychological health. The purpose of this research was to predict resilience based on cognitive emotion regulation strategies and perceived social support with the mediating role of self-efficacy in breast cancer patients.
Materials and Methods: The present study was descriptive and correlational. The statistical population consisted of all women with breast cancer who had an active case in the oncology departments of Imam Khomeini (RA) and Imam Hossein (AS) Hospitals in Tehran in 2023. Two-hundred and fifty individuals were selected using the convenience sampling method. Data collection tools included the Cognitive Emotion Regulation Questionnaire (CERQ) by Garnefski et al. (2001), the Resilience Scale (RISC) by Connor and Davidson (2003), the Perceived Social Support Scale (MSPSS) by Zimet et al. (1988), and the General Self-Efficacy Scale (GSES) by Scherer et al. (1982). The Pearson’s correlation coefficient and structural equation modeling were used for the statistical analysis of the data.
Results: The findings showed that maladaptive cognitive emotion regulation (β=-0.26, p=0.002), adaptive cognitive emotion regulation (β=0.39, p=0.001), perceived social support (β=0.22, p=0.001), and self-efficacy (β=0.29, p=0.001) have a direct and significant effect on resilience. Cognitive emotion regulation strategies and perceived social support, with the mediation of self-efficacy, explain a total of 43% of the variance in resilience. Additionally, the final research model demonstrated a good fit.
Conclusion: Given the mediating role of self-efficacy in the relationship between cognitive emotion regulation strategies and perceived social support with resilience in women with breast cancer, it is recommended that targeted interventions be implemented to enhance resilience by improving emotion regulation, increasing social support, and strengthening self-efficacy, thereby supporting the mental health of these patients.
Keywords: Resilience, Self-efficacy, Cognitive emotion regulation strategies, Perceived social support, Breast cancer
Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of University of Kashan approved the study (IR.KASHANU.REC.1402.040).
Authors’ contributions:
- Conceptualization: Mohammad Reza Tamannaeifar
- Methodology: Mohammad Reza Tamannaeifar
- Data collection: Zahra Suleimanian
- Formal analysis: Zahra Suleimanian
- Supervision: Mohammad Reza Tamannaeifar
- Project administration: Mohammad Reza Tamannaeifar
- Writing – original draft: Mohammad Reza Tamannaeifar, Zahra Suleimanian
- Writing – review & editing: Mohammad Reza Tamannaeifar, Zahra Suleimanian
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Citation: Tamannaeifar MR, Suleimanian Z. Structural Equation Modeling of Resilience Based on Cognitive Emotion Regulation Strategies and Perceived Social Support with the Mediating Role of Self-Efficacy in Breast Cancer Patients: A Descriptive Study. J Rafsanjan Univ Med Sci 2025; 24 (4): 360-74. [Farsi]
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[1]- Associate Prof., Dept. of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran, ORCID: 0000-0003-0858-7216
(Corresponding Author) Tel: 09131616609, E-mail: tamannai@kashanu.ac.ir
[2]- MA in Psychology, Dept. of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran
[2]- MA in Psychology, Dept. of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran
Type of Study: Research |
Subject:
Nursing
Received: 2025/02/10 | Accepted: 2025/05/25 | Published: 2025/07/19
Received: 2025/02/10 | Accepted: 2025/05/25 | Published: 2025/07/19
References
1. Fuentes JD, Morgan E, de Luna Aguilar A, Mafra A, Shah R, Giusti F, et al. Global stage distribution of breast cancer at diagnosis: a systematic review and meta-analysis. JAMA Oncology 2024; 10(1): 71-8.
2. Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast 2022; 66(1): 15-23.
3. Gradishar WJ, Moran MS, Abraham J, Abramson V, Aft R, Agnese D, et al. Breast cancer, version 3.2024, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network 2024; 22(5): 331-57.
4. Haghighat S, Omidi Z, Ghanbari-Motlagh A. Trend of Breast Cancer Incidence in Iran During A Fifteen-Year Interval According To National Cancer Registry Reports. Iranian Journal of Breast Diseases 2022; 15(2): 4-17.
5. Minami CA, Jin G, Freedman RA, Schonberg MA, King TA, Mittendorf EA. Trends in locoregional therapy in older women with early-stage hormone receptor-positive breast cancer by frailty and life expectancy. Annals of surgical Oncology 2024; 31(2): 920-30.
6. Peeters NV, Vlooswijk C, Bijlsma RM, Kaal SE, Kerst JM, Tromp JM, et al. Sexual quality of life of adolescents and young adult breast cancer survivors. ESMO Open 2024; 9(2): 1-10.
7. Zhang Q, Wu G, Chen J, Fang K, Liu Q, Zhang P, et al. Factors influencing depressive symptoms in Chinese female breast cancer patients: a meta-analysis. Frontiers in Psychology 2024; 15(1): 1-10.
8. Yang K, Ren Y, Peng W, Wang X, Du X, Wang J, et al. Subjective well-being among Chinese breast cancer patients: The unique contributions of death anxiety, self-esteem, and social support. Journal of Health Psychology 2024; 29(3): 213-24.
9. Budisavljevic A, Dedic Plavetic N, Klaric K, Kelemenic-Drazin R, Letica-Crepulja M. The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health. International Journal of Environmental Research and Public Health 2024; 21(6): 677-88.
10. Aizpurua-Perez I, Arregi A, Gonzalez D, Macia P, Ugartemendia G, Labaka A, et al. Resilience in newly diagnosed breast cancer women: the predictive role of diurnal cortisol and social support. Biological Research for Nursing 2024; 26(1): 68-77.
11. Denckla CA, Cicchetti D, Kubzansky LD, Seedat S, Teicher MH, Williams DR, et al. Psychological resilience: An update on definitions, a critical appraisal, and research recommendations. European Journal of Psychotraumatology 2020; 11(1): 1-10.
12. Al Jowf GI, Ahmed ZT, An N, Reijnders RA, Ambrosino E, Rutten BP, et al. A public health perspective of post-traumatic stress disorder. International Journal of Environmental Research and Public Health 2022; 19(11): 1-10.
13. Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. European Journal of Psychotraumatology 2014; 5(1): 1-10.
14. Liang MZ, Tang Y, Knobf MT, Molassiotis A, Chen P, Hu GY, et al. Resilience index improves prediction of 1-year decreased quality of life in breast cancer. Journal of Cancer Survivorship 2023; 17(3): 759-68.
15. Ye ZJ, Zhang Z, Tang Y, Liang J, Sun Z, Hu GY, et al. Resilience patterns and transitions in the Be Resilient to Breast Cancer trial: an exploratory latent profile transition analysis. Psycho Oncology 2021;30(6): 901-9.
16. Tamannaeifar MR, Suleimanian Z. The Mediating Role of Resilience and Self-Efficacy in Relationship between Cognitive Emotion Regulation Strategies and Psychological Distress in Women with Breast Cancer. Journal of Psychological Studies 2024; 20(1): 55-70.
17. Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol 2003; 85(2): 348-62.
18. Ben-Artzi TJ, Baziliansky S, Cohen M. The associations of emotion regulation, self-compassion, and perceived lifestyle discrepancy with breast cancer survivors’ healthy lifestyle maintenance. Journal of Cancer Survivorship 2024; 24(1): 1-0.
19. Guimarães I, Torres S, Vieira AI, Jönsson C, Prista Guerra M, Lencastre L. Difficulties in emotion regulation and well-being in breast cancer. Health Psychology and Behavioral Medicine 2024; 12(1): 1-10.
20. Tamannaeifar M, Soleimanian Z. The mediating role of resilience and self-efficacy in the relationship between perceived social support and psychological distress in breast cancer patients. Feyz Med Sci J 2024; 28(1): 76-85.
21. Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psychological Trauma: Theory, Research, Practice, and Policy 2020; 12(1): 55-7.
22. Zysberg L, Zisberg A. Days of worry: Emotional intelligence and social support mediate worry in the COVID-19 pandemic. Journal of Health Psychology 2022; 27(2): 268-77.
23. Farahbakhshbeh S, Mehri Nejad SA, Moazedian A. Predicting Self-Efficacy of Women with Breast Cancer based on Quality of Life, Religious Orientation, Resilience, Death Anxiety, Psychological Hardiness and Perceived Social Support. Iranian Journal of Health Psychology 2019; 2(1): 65-78.
24. Wang X, Gao Y, Wang Q, Zhang P. Relationships between self-efficacy and teachers’ well-being in middle school English teachers: The mediating role of teaching satisfaction and resilience. Behavioral Sciences 2024; 14(8): 629-39.
25. Caprara GV, Steca P, Gerbino M, Paciello M, Vecchio GM. Looking for adolescents' well-being: Self-efficacy beliefs as determinants of positive thinking and happiness. Epidemiology and Psychiatric Sciences 2006; 15(1): 30-43.
26. Tzenios N, Tazanios ME, Chahine M. The impact of BMI on breast cancer–an updated systematic review and meta-analysis. Medicine 2024; 103(5): 1-10.
27. Sun YS, Zhao Z, Yang ZN, Xu F, Lu HJ, Zhu ZY, et al. Risk factors and preventions of breast cancer. International Journal of Biological Sciences 2017; 13(11): 1-10.
28. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA: A Cancer Journal for Clinicians 2016; 66(1): 31-42.
29. Kordnoghabi R, Veisi S. Developing a Model of Wisdom Based on Successful Intelligence and Psychological Well-Being in Students: The Mediating Role of Creativity. Positive Psychology Research 2024; 10(3): 29-50. [Farsi]
30. Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Journal Personality and Individual Differences 2001; 30(8): 1311-27.
31. Derogatis LR, Lipman RS, Covi L. SCL-90. Administration, scoring and procedures manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scales Series. Chicago: Johns Hopkins University School of Medicine 1977.
32. Beck AT, Steer, RA, Brown GK. Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation 1996.
33. Hasani J. The Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ). Journal of Clinical Psychology 2010; 2(3): 73-84. [Farsi]
34. Conner KM, Davidson JR. Development of a new resilience scale. Depression and Anxiety 2003; 18(1): 76-82.
35. McGahuey CA, Gelenberg AJ, Laukes CA, Moreno FA, Delgado PL, McKnight KM, et al. The Arizona sexual experience scale (ASEX): reliability and validity. Journal of Sex and Marital Therapy 2000; 26(1): 25-40.
36. Ahangarzadeh Rezaei S, Rasoli M. evaluate psychometric properties of the Persian version of Conner-Davidson resilience scale in adolescents with cancer. Nursing and Midwifery Journal 2015; 13(9): 739-47. [Farsi]
37. Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychological Reports 1982; 51(2): 663-71.
38. Rosenberg M. Determinants of self-esteem-a citation classic commentary on society and the adolescent self-image by Rosenberg, M. Current Contents/Social & Behavioral Sciences 1989; 1(11): 16.
39. Rezaei Rad M, Zarofian F, Majani N, Rezaei Rad M. The relationship of self-efficacy with self-regulated learning in the virtual education of students during the Covid-19 epidemic. Journal of Nursing Education 2023; 12(2): 15-24. [Farsi]
40. Zimet D, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment 1988; 52(1): 30-
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