Structural equation modeling: a study of the impact of the breast cancer psychosocial pathway (diagnosis, surgery and treatment)

Ivone Patrão, Isabel Leal, João Maroco


Objective: Women diagnosed with breast cancer are confronted with different stressors throughout the illness trajectory, e.g. awaiting diagnosis, having surgery, anticipating the possibility that the cancer has spread and coping with side effects. The aim of this study was to assess the impact of the psychosocial pathway of breast cancer. Methods: A total of 360 women diagnosed with breast cancer were evaluated, on 3 separate occasions, regarding: distress, emotional control, neuroticism, social support, coping, quality of life (QoL) and demographic characteristics. We used structural equation modeling (SEM) to examine the relationships among all the variables. Results: The emotional, cognitive response, and the QoL suffered significant changes concerning diagnosis (time 1), surgery (time 2) and treatments (time 3). Furthermore, results indicate that an adapted emotional response is associated to efficient coping strategy, and satisfaction with the perceived social support and good QoL. This is particularly the case when women are undergoing a psychological intervention. Conclusion: To help breast cancer patients adjust to their situation the clinical psychologist should encourage the patient to adopt more efficient coping strategies. By doing so, patients may indeed experience less psychological distress and a higher quality of life, thereby increasing their overall sense of well-being.


breast cancer; psychosocial pathway; psychosocial adjustment