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The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients

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Abstract

Purpose

Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients.

Method

A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress.

Results

According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (β =  − 0.107, p = 0.008) and social support (β =  − 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (β =  − 0.185, p < 0.001), and perceived stigma had a direct effect on social support (β =  − 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients.

Conclusions

Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The research team gratefully acknowledges the supervisors of the hospitals and the 441 lung cancer patients who voluntarily participated in the study, as well as the experts and members of the group for their help and advice.

Funding

This study was supported by Grant from the Technological Innovation and Demonstrational Application Project of Chongqing Science and Technology Bureau (project no. cstc2018jscx-msybX0030) and Chongqing Natural Science Foundation (project no. cstc2018jcyjAX0737s). The founder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Author notes

  1. Hui Lei and Xu Tian contributed equally to this work.

Authors and Affiliations

  1. Department of Nursing, Wuchuan People’s Hospital, Wuchuan, Guangdong, 524500, People’s Republic of China

    Hui Lei

  2. Nursing Faculty, Universitat Rovira I Virgili, 43002, Tarragona, Spain

    Xu Tian, Yan-Fei Jin & Maria F. Jiménez-Herrera

  3. Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China

    Xu Tian, Ling Tang & Wei-Qing Chen

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  1. Hui Lei
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  2. Xu Tian
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  3. Yan-Fei Jin
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  4. Ling Tang
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  6. Maria F. Jiménez-Herrera
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Contributions

Xu Tian had full access to all of the data in the study and held responsible for the integrity of the data and accuracy of the data analysis. Concept and design: Hui Lei, Xu Tian and Maria F. Jiménez-Herrera. Acquisition, analysis, or interpretation of data: Hui Lei, Xu Tian, Yan-Fei Jin, and Ling Tang. Drafting of the manuscript: Hui Lei, Xu Tian, and Hui Chen. Critical revision of the manuscript for important intellectual content: Wei-Qing Chen and Maria F. Jiménez-Herrera. Statistical analysis: Lei Hui and Xu Tian. Obtaining funding: Xu Tian. Administrative, technical, or material support: Wei-Qing Chen. Supervision: Maria F. Jiménez-Herrera.

Corresponding authors

Correspondence to Wei-Qing Chen or Maria F. Jiménez-Herrera.

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Lei, H., Tian, X., Jin, YF. et al. The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients. Support Care Cancer 29, 6761–6770 (2021). https://doi.org/10.1007/s00520-021-06278-7

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