Structural Model of Adjustment to Cancer based on Paradigm Scenarios and mediating Role of Illness Perception
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Objective: This study examined a structural model of cancer adaptation based on emotional macro-narratives, with illness perception as a mediating variable.
Methods and Materials: This descriptive-correlational study used structural equation modeling. The sample included 400 patients with cancer referred to medical centers in Tehran, Iran, in 2024, selected through convenience sampling. Data were collected using the Cancer Adjustment Questionnaire, Brief Illness Perception Questionnaire, and a researcher-designed Emotional Macro-Narratives Questionnaire. Data were analyzed using SPSS-24 and AMOS-24.
Findings: The model showed excellent fit: χ² = 1.789, df = 2, p = 0.621, CMIN/DF = 0.894, RMSEA = 0.001, SRMR = 0.008, CFI = 0.996, IFI = 0.993, and GFI = 0.923. The model explained 67.8% of the variance in cancer adaptation. Heroic narrative (β= 0.340, p< 0.001), personal growth (β= 0.553, p < 0.001), solidarity (β = 0.360, p< 0.001), acceptance (β= 0.384, p< 0.001), and illness perception (β= 0.503, p< 0.001) positively predicted adaptation. Victim narrative (β= −0.501, p< 0.001) and emotional contradictions (β = −0.284, p< 0.001) negatively predicted adaptation. Illness perception significantly mediated the effects of all emotional macro-narratives on adaptation.
Conclusion: Emotional macro-narratives influence adaptation to cancer both directly and indirectly through illness perception. Strengthening adaptive narratives and modifying illness perceptions may improve psychosocial adjustment in patients with cancer.
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