Predictors of return-to-work adaptability in young breast cancer patients: A structural equation model analysis of individual resilience, self-perceived burden, and family resilience.

PURPOSE: To examine the predictive roles of family resilience, individual resilience, and self-perceived burden (SPB) on return-to-work adaptability (RTWA) in younger Chinese breast cancer patients.

METHODS

A multicenter cross-sectional study was conducted utilizing structural equation modeling, with 356 breast cancer survivors aged 18-49 years recruited from five tertiary hospitals in Sichuan Province, China. Validated scales were used to measure family resilience, individual resilience, SPB, and RTWA. Data were analyzed using Pearson correlation and structural equation modeling with SPSS 23.0 and Amos 23.0.

RESULTS

Family resilience exerted a significant positive direct effect on individual resilience (β = 0.312, P < 0.01) and RTWA (β = 0.141, P < 0.01), and a significant negative effect on SPB (β =  - 0.238, P < 0.01). Individual resilience was negatively associated with SPB (β =  - 0.673, P < 0.001) and positively predicted RTWA (β = 0.168, P < 0.01), while SPB was negatively associated with RTWA (β =  - 0.156, P < 0.01). Three significant mediation effects were confirmed: individual resilience mediated the relationship between family resilience and RTWA (β = 0.085, P < 0.01); SPB mediated this relationship (β = 0.037, P < 0.01); and a chain mediation effect via individual resilience and SPB was significant (β = 0.052, P < 0.01).

CONCLUSION

Family resilience serves as a foundational resource for successful occupational reintegration among young breast cancer survivors, exerting direct positive effects on RTWA and indirect effects by promoting individual resilience and alleviating SPB.