Avoidant coping as mediator of the relationship between rumination and mental health among family caregivers of Chinese breast cancer patients

Abstract

Introduction: Family caregivers of cancer patients were often referred to the 'forgotten patients', yet little researches have been conducted on their mental health. Rumination might put family caregivers at risk for psychological distress during the caregiving, such as stress and anxiety. The aim of the present study was to explore the relationship between rumination, stress and anxiety among family caregivers of breast cancer patients in China and examine the mediating role of avoidant coping in this relationship.Methods: Face-to-face questionnaire interviews were conducted with a sample of 99 caregivers from the public oncology hospital. They were assessed with stress, anxiety, rumination and avoidant coping by Chinese Perceived Stress Scale, Zung's Self-Rating Anxiety Scale, Ruminative Responses Scale and Coping Strategy Indicator.Structural equation modelling was applied to assess the mediation analysis. Results:The reporting scores of participants indicated the incidence of anxiety was 17.2%. Rumination could directly predict stress (β = 0.58, p < 0.01) and anxiety (β = 0.46, p < 0.01) and also predict stress and anxiety via the mediator of avoidant coping (stress: β = 0.087, p < 0.01; anxiety: β = 0.109, p < 0.01). Conclusions:The important role played by family caregivers in supporting breast cancer patients is well recognised. The findings suggested that rumination and avoidant coping may be two critical risk factors for family caregivers of breast cancer developing stress and anxiety. This study highlights the importance of preventing avoidant coping, which plays a critical role for developing interventions for this vulnerable group.

Relation Between Maladaptive Metacognitive Beliefs and Burden in Caregivers of Psychiatric Patients: Role of Resilience as a Moderator and Rumination as a Mediator

“…For further explanation, Yuanyuan and Chen (2021) agreed this result through their study for how rumination predicted ineffective coping and stress. They mentioned that caregivers with ideas such as catastrophic appraisals and worrying thoughts regarding burden, their maladaptive metacognitive thoughts or behaviors could increase.…”

Decoding Caregiver Burden in Cancer: Role of Emotional Health, Rumination, and Coping Mechanisms

“…Our research identified rumination as a significant mediating factor between stress, depression, and caregiver burden. Rumination, or the persistent dwelling on distressing thoughts, can amplify the impact of stress and depression on caregiver burden, under-lining the vital role of psychological factors and coping strategies in managing caregiver burden [39].…”

“…This distress can further compound caregiver burden. Moreover, rumination often encourages avoidant coping strategies, representing a risk factor for higher stress and anxiety levels [39].…”

Covid‐19‐related ruminations: A qualitative study based on the perspectives of the cancer survivors

“…According to Response Style Theory (RST), rumination enhances maladaptive coping and dysfunctional attitudes, which impair problem-solving and intensify emotional distress (Nolen-Hoeksema et al, 2008). Similar to the perspective of RST, in the literature it is evident that individuals with cancer are prone to focus on intrusive ruminations (Öcalan & Üzar-Özçetin, 2021;Renna et al, 2021;Tan et al, 2021). This subsequently leads to catastrophic cognitions (e.g., "What did I do to deserve this?…”

“…By contrast, deliberate rumination aids individuals in understanding the distress that they are experiencing (Kamijo & Yukawa, 2018). As a result, it has greater value in shaping the consequences (Tan et al, 2021). According to Response Style Theory (RST), rumination enhances maladaptive coping and dysfunctional attitudes, which impair problem‐solving and intensify emotional distress (Nolen‐Hoeksema et al, 2008).…”