Identifying the heterogeneity of self-advocacy in patients with gynecological cancer: a latent class profile analysis

Gynecological cancers lead to a heavy global disease burden and severe physical and psychological distress. Self-advocacy can improve patients’ prognosis and quality of life. This study aimed to explore self-advocacy in patients with gynecological cancer and evaluate heterogeneity among different subgroups. We conducted a cross-sectional analysis using baseline data from a longitudinal survey that assessed the self-advocacy of patients with gynecological cancer who received cancer treatment at a hospital in Fujian, China (N = 155). We identified latent classes based on the subdomains of the Chinese Version of the Female Self-Advocacy in Cancer Survivorship Scale (FSACS) using latent class profile analysis and then examined the factors related to latent class membership using multinomial logistic regression and correlation analyses. Two latent classes were identified: low-level FSACS (Type 1, 29.7%) and high-level FSACS (Type 2, 70.3%). Logistic regression showed that age and treatment methods were predictive factors for the potential category grouping of self-advocacy among gynecological cancer survivors (P < 0.05). The total FSACS score of gynecological cancer survivors was 66.78 ± 17.86. There was a positive correlation between the total FSACS scores and confrontation (r = 0.197, P < 0.05), subjective support (r = 0.181, P < 0.05), and utilization of support (r = 0.263, P < 0.05). This study has several limitations, including a cross-sectional design that restricts causal inference and a single-hospital sample that may reduce external validity and introduce selection bias. Patients in various subgroups displayed personalized self-advocacy. Older age and multimodal therapy options may significantly increase the risk in individuals with low self-advocacy. Healthcare providers should implement targeted strategies to enhance self-advocacy among this population.