Asia-Pacific journal of oncology nursing · 2026
Reproductive concerns and fertility intention among reproductive-age Chinese women with breast cancer: A multiple mediation analysis.
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Li Shan, Geng Qingchun, Zhou Yaqin, Wang Lili, Jin Yanfei
Аннотация
OBJECTIVE: This study investigated the relationship between reproductive concerns and fertility intentions among reproductive-age Chinese women with breast cancer, examining the mediating roles of fertility information needs, perceived social support, and marital intimacy.
METHODS: A cross-sectional study was conducted from April 2025 to September 2025 among 463 married reproductive-age women with breast cancer. Participants completed validated questionnaires assessing fertility intentions, reproductive concerns, fertility information needs, perceived social support, and marital intimacy. Structural equation modeling was employed to test a parallel multiple mediation model, with place of residence and number of children included as covariates.
RESULTS: The mean fertility intention score was 42.77 ± 5.49. Reproductive concerns demonstrated a significant negative direct effect on fertility intentions (β = -0.278, 95% CI [-0.353, -0.179]), accounting for 58.4% of the total effect. All three hypothesized mediators showed significant indirect effects: perceived social support (β = -0.089, 95% CI [-0.133, -0.050], 18.7% of total effect), marital intimacy (β = -0.077, 95% CI [-0.119, -0.042], 16.2% of total effect), and fertility information needs (β = -0.032, 95% CI [-0.060, -0.011], 6.7% of total effect). The total indirect effect through all three mediators was significant (β = -0.198, 95% CI [-0.268, -0.128]), accounting for 41.6% of the total effect.
CONCLUSIONS: Reproductive concerns were associated with lower fertility intention, partly through their associations with lower fertility information needs, perceived social support, and marital intimacy. Health care providers should provide proactive, needs-responsive fertility counseling, strengthen social support, and promote couple-centered communication to support informed reproductive decision-making.
METHODS: A cross-sectional study was conducted from April 2025 to September 2025 among 463 married reproductive-age women with breast cancer. Participants completed validated questionnaires assessing fertility intentions, reproductive concerns, fertility information needs, perceived social support, and marital intimacy. Structural equation modeling was employed to test a parallel multiple mediation model, with place of residence and number of children included as covariates.
RESULTS: The mean fertility intention score was 42.77 ± 5.49. Reproductive concerns demonstrated a significant negative direct effect on fertility intentions (β = -0.278, 95% CI [-0.353, -0.179]), accounting for 58.4% of the total effect. All three hypothesized mediators showed significant indirect effects: perceived social support (β = -0.089, 95% CI [-0.133, -0.050], 18.7% of total effect), marital intimacy (β = -0.077, 95% CI [-0.119, -0.042], 16.2% of total effect), and fertility information needs (β = -0.032, 95% CI [-0.060, -0.011], 6.7% of total effect). The total indirect effect through all three mediators was significant (β = -0.198, 95% CI [-0.268, -0.128]), accounting for 41.6% of the total effect.
CONCLUSIONS: Reproductive concerns were associated with lower fertility intention, partly through their associations with lower fertility information needs, perceived social support, and marital intimacy. Health care providers should provide proactive, needs-responsive fertility counseling, strengthen social support, and promote couple-centered communication to support informed reproductive decision-making.