The Structural Model of the Relationships between Perceived Stigma, Fear of Recurrence, and Psychological Flexibility with Psychological Distress in Women with Breast Cancer

The present study aimed to investigate the relationships between perceived stigma and fear of recurrence with psychological distress in women with cancer, with the mediating role of psychological flexibility. The present cross-sectional study employed a correlational design. The research population consisted of women with breast cancer who visited healthcare centers in Tehran between March 2023 and October 2023, and 220 individuals were selected from three medical centers, using a convenience sampling method. Data were collected using Kessler psychological distress scale, fear of cancer recurrence inventory-short form, stigma scale for chronic illnesses, and Acceptance and Action Questionnaire-II, and analyzed using Pearson correlation and structural equations test, with / without, controlling for age effect. The results of the model test showed that fear of recurrence had no direct effect on distress, but perceived stigma and psychological flexibility had a direct effect on distress. Also, psychological flexibility mediated the relationship between fear of recurrence and perceived stigma with distress. Therefore, to design programs to reduce psychological distress in women with breast cancer, it is necessary to address reducing perceived stigma and fear of recurrence and especially promoting their psychological flexibility.