Sense of coherence mediates perceived social support and depressive and anxiety symptoms in cervical cancer patients: a cross-sectional study

BMC Psychiatry. 2023 May 4;23(1):312. doi: 10.1186/s12888-023-04792-y.

Abstract

Background: Depression and anxiety symptoms are two common psychological disturbances in cervical cancer patients. We tested whether sense of coherence (SOC) mediates the association of perceived social support (PSS) with depression and anxiety symptoms among cervical cancer patients in China.

Methods: We conducted a survey involving 294 cervical cancer patients aged ≥ 18 years from July to December 2020 at three hospitals in Liaoning Province, China; 269 patients completed the survey. We included a demographic questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS), Antonovsky's Sense of Coherence Scale, the Hamilton Depression Rating Scale, and the Zung Self-Rating Anxiety Scale (SAS) in this study. We used hierarchical regression analysis to examine the relationship among PSS, SOC, and symptoms of depression and anxiety. We used asymptotic and resampling strategies to explore the mediating effect of SOC.

Results: PSS was negatively associated with depressive symptoms (r = - 0.439, P < 0.01) and anxiety symptoms (r = - 0.325, P < 0.01). SOC was negatively related to depressive symptoms (r = - 0.627, P < 0.01) and anxiety symptoms (r = - 0.411, P < 0.01). SOC partially mediated the association between PSS and depressive symptoms (a*b = - 0.23, BCa95% CI: [- 0.31, - 0.14]) and anxiety symptoms (a*b = - 0.15, BCa95% CI: [- 0.23, - 0.08]). The proportions of the mediating effect accounting for SOC were 49.78% and 41.73% for depressive symptoms and anxiety symptoms, respectively.

Conclusion: The study showed that SOC could mediate the association between PSS and symptoms of depression and anxiety. This suggests that SOC might serve as a potential target for intervention in symptoms of depression and anxiety that accompany cervical cancer.

Keywords: Cervical cancer; Depressive and anxiety symptoms; Mediating role; Perceived social support; Sense of coherence.

MeSH terms

  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / psychology
  • Female
  • Humans
  • Sense of Coherence*
  • Social Support
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms* / complications