Current status and influencing factors of emotional suppression in Chinese female breast cancer patients

Abstract

Objective: To analyze the level of emotional suppression and the factors influencing it in female breast cancer patients in Henan Province, China, and to provide theoretical support for nursing managers to prevent and improve emotional suppression in breast cancer patients, and to improve the quality of life of breast cancer patients.

Methods: A convenience sampling method was used to select 143 breast cancer patients admitted and hospitalized in the oncology departments of three tertiary hospitals in Luoyang City, Henan Province, China, from November 2023 to January 2024 as the study subjects. A general information questionnaire, an emotional suppression scale, and a family support care index questionnaire were used to conduct the survey.

Results: The total score of emotional suppression in breast cancer patients was (32.73 ± 6.59). The results of multiple regression showed that education, disease stage, pain level, and family support were the main influencing factors of emotional inhibition in breast cancer patients (all p ＜.05).

Discussion: Emotional suppression of breast cancer patients in Henan Province is at a medium level; Health care workers and family members should pay more attention to the psychological changes of patients, implement effective nursing interventions, provide positive psychological support, and reduce the psychological burden of patients, to significantly reduce the degree of emotional suppression of patients.

Keywords

Breast cancer / Cancer / Emotional inhibition / Influencing factors / Psychological change

References

[1] Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: cancer today(EB/OL). (2020-01-01)(2022-11-07).

[2] Wei C, Da HC, Wen YY, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chinese Medical Journal. 2021; 134(7): 783-791. PMid:33734139 https://doi.org/10.1097/CM9.0000000000001474

[3] Di Meglio A, Havas J, Gbenou AS, et al. Dynamics of long-term patient-reported quality of life and health behaviors after adjuvant breast cancer chemotherapy. J Clin Oncol. 2022; 40(27): 3190-3204. PMid:35446677 https://doi.org/10.1200/JCO.21.00277

[4] Liu LP. Chinese revision of the Emotional Inhibition Scale and its application in cancer patients. Guangzhou: Southern Medical University. 2020.

[5] Snatucci C, Carioli G, Ber Tuccio P, et al. Progress in cancer mortality, incidence, and survival: a global overview. Cancer Prew. 2020; 29(5): 367-381. PMid:32740162 https://doi.org/10.1097/CEJ.0000000000000594

[6] Łuczyk RJ, Sikora K, Bodio A, et al. Role of emotional control on anxiety and stress among cancer patients. Cancer Med. 2024 Sep; 13(18): e70162. PMid:39300954 https://doi.org/10.1002/cam4.70162

[7] Brandaot, Tavaersr, Schulzms, et al. Measuring emotion regulation and emotional expression in breast cancer patients: a systematic review. Clin Psychol Rev. 2016; 43(15): 114-127. PMid:26520599 https://doi.org/10.1016/j.cpr.2015.10.002

[8] Ciulucicac, Fulcherim, Ameriop. Expressive suppression and negative affect, pathways of emotional dysregulation in psoriasis patients. Front Psychol. 2019; 10(7): 190-197. PMid:31496974 https://doi.org/10.3389/fpsyg.2019.01907

[9] Baziliansky S, Cohen M. Emotion regulation patterns among colorectal cancer survivors: clustering and associations with personal coping resources. Behav Med. 2021; 47(3): 214-224. PMid:32275195 https://doi.org/10.1080/08964289.2020.1731674

[10] NAKATANI Y, IWAMITSU Y, KURANAMI M, et al. The relationship between emotional suppression and psychological distress in breast cancer patients after surgery. Japanese Journal of Clinical Oncology. 2014; 44(9): 818-825. PMid:25028697 https://doi.org/10.1093/jjco/hyu089

[11] LU Q, TSAI W, CHU Q, et al. Is expressive suppression harmful for Chinese American breast cancer survivors? Journal of Psychosomatic Research. 2018; 109: 51-56. PMid:29773152 https://doi.org/10.1016/j.jpsychores.2018.03.171

[12] CHAPMAN BP, FISCELLA K, KAWACHI I, et al. Emotion suppression and mortality risk over a 12-year follow-up. Journal of Psychosomatic Research. 2013; 75(4): 381-385. PMid:24119947 https://doi.org/10.1016/j.jpsychores.2013.07.014

[13] Smilkstein G, Ashworth C, Momtano D. Validity and reliability of the family APGAR as a test of family function. Fam Pract. 1982; 15(2): 303-311. PMid:7174773 https://doi.org/10.1016/0021-9681(82)90122-9

[14] Ohnhaus EE, Adler R. Methodological problems in the measurement of pain: a comparison between the verbal rating scale and the visual analog scale. Pain. 1975 Dec; 1(4): 379-384. PMid:800639 https://doi.org/10.1016/0304-3959(75)90075-5

[15] Grandi S, Sirri L, Wise T N, et al. Kellner’s Emotional Inhibition Scale: a clinimetric approach to alexithymia research. Psychotherapy and Psychosomatics. 2011; 80(6): 335-344. PMid:21829045 https://doi.org/10.1159/000328576

[16] PENG YT, ZHU YF, MA SH, et al. Analysis of the current situation of emotional suppression and its influencing factors in breast cancer patients. PLA Nursing Journal. 2022; 39(3): 40-43. https://doi.org/10.3969/j.issn.1008-9993.2022.03.010

[17] Grandi, Silvana, Sirri, et al. Kellner’s Emotional Inhibition Scale: A Clinimetric Approach to Alexithymia Research. Psychotherapy & Psychosomatics. 2011; 80(6): 335-344. PMid:21829045 https://doi.org/10.1159/000328576

[18] LIU J, ZHANG YJ, YANG YJ, et al. Survey on the current status of psychological resilience of young and middle-aged maintenance hemodialysis patients and its influencing factors. China Blood Purification. 2019; 18(8): 571-574. https://doi.org/10.3969/j.issn.1671-4091.2019.08.016

[19] Smith S, Lally P, Steptoe A, et al. Prevalence of loneliness and associations with health behaviors and body mass index in 5835 people living with and beyond cancer: a cross-sectional study. BMC Public Health. 2024; 24(1): 635-635. PMid:38419011 https://doi.org/10.1186/s12889-024-17797-3

[20] You J, Wang C, Yeung NCY, et al. Socioeconomic status and quality of life among Chinese American breast cancer survivors: the mediating roles of social support and social constraints. Psychooncology. 2018; 27(7): 1742-1749. PMid:29603490 https://doi.org/10.1002/pon.4719

[21] Cruz Pico CX, Pierotti ML, Hasler JS, et al. Disparities in the recommendation, acceptance, and performance of surgery as a treatment modality for patients with stage 0-III breast cancer. Journal of Clinical Oncology. 2023; 41(16-Sup): e18509-e18509. https://doi.org/10.1200/JCO.2023.41.16_suppl.e18509

[22] ZHOU ZN, DAI JN, ZHANG QZ, et al. Meta-analysis of the effect of dignity therapy on the intervention of dignity status and negative emotions in patients with advanced cancer. Nursing and Rehabilitation. 2021; 20(10): 6-10.

[23] Roose E, Cools W, Leysen L, et al. Psychological Factors Influencing Healthcare Utilization in Breast Cancer Survivors with Pain. Pain medicine (Malden, Mass.). 2024. PMid:39163503 https://doi.org/10.1093/pm/pnae083

[24] LI YL, YANG Y, LI TT. Analysis of research hotspots for cancer pain management in China based on keyword co-occurrence. General Practice Nursing. 2021; 19(16): 2175-2179.

[25] YU WH, YANG H, MA XX, et al. A study of pain management outcomes and healthcare professionals’ pain management behaviors in hospitalized cancer patients. Chinese Journal of Pain Medicine. 2021; 27(5): 393-396.

[26] Chen LQ, He BY, Huang QL. Analysis of factors affecting cancer eruption pain and countermeasures for standardized pain management in middle and advanced cancer patients. Qilu Nursing Journal. 2021; 27(11): 141-143.

[27] Unji An, Park HG, Han DE, et al. Emotional Suppression and Psychological Well-Being in Marriage: the Role of Regulatory Focus and Spousal Behaviour. International Journal of Environmental Research and Public Health. 2022; 19(2): 10. PMid:35055793 https://doi.org/10.3390/ijerph19020973

[28] Bian J, Zhang LF, Liu TT, et al. Analysis of factors influencing family carers’ sense of disease benefit in cancer patients based on stress coping theory. Journal of Nurse Advancement. 2019; 34(23): 2203-2207.

[29] Pedro G, Paula M M, Eunice R S, et al. Distress facing increased genetic risk of cancer: the role of social support and emotional suppression. Patient Education & Counseling. 2022; 105(7): 2436-2442. PMid:35339327 https://doi.org/10.1016/j.pec.2022.03.018

[30] WARMOTH K, CHEUNG B, YOU J, et al. Exploring the social needs and challenges of Chinese American immigrant breast cancer survivors: a qualitative study using an expressive writing approach. International Journal of Behavioral Medicine. 2017; 24(6): 827-835. PMid:28585073 https://doi.org/10.1007/s12529-017-9661-4

[31] YAO J, TONG LL. The impact of Rosenthal effect intervention on fear of recurrence and emotional suppression in breast cancer patients after surgery. Journal of General Medicine Clinical and Education. 2021; 19(1): 83-85.

[32] VILLANI D, COGNETTA C, REPETTO C, et al. Promoting emotional well-being in older breast cancer patients: results from an eHealth intervention. Frontiers in Psychology. 2018; 9: 2279. PMid:30538650 https://doi.org/10.3389/fpsyg.2018.02279

[33] Szaszkó B, Schmid RR, Pomper U, et al. The influence of hatha yoga on stress, anxiety, and suppression: A randomized controlled trial. Acta Psychologica. 2023; 241. PMid:37931334 https://doi.org/10.1016/j.actpsy.2023.104075

[34] ZHANG YJ, QIAN C, LU H, et al. Meta-analysis of the impact of mindfulness therapy on quality of life and negative emotions in breast cancer patients after surgery. Chinese Medical Herald. 2020; 17(25): 164-167, 183.