Mediating Effect Of Stigma On Body Image And Sexual Dysfunction In Female Breast Cancer Patients After Operation

Objective:This paper investigates the status quo and influencing factors of stigma,body image and sexual dysfunction after breast cancer surgery,analyzes the relationship between stigma,body image and sexual dysfunction,and establishes the structural equation model to further explore the mediating effect of stigma on body image and sexual dysfunction.Methods:In this paper,the convenience sampling method was used to select 266 patients with breast cancer after operation in a third class hospital in Jiangxi Province from January 2021 to August 2021.A cross-sectional survey was conducted.The general information questionnaire,the Chinese version of the stigma experience questionnaire,the Chinese version of the body image scale and the Chinese version of the Arizona sexual experience scale were used to investigate the socio demographic situation,the level of stigma Body image level and sexual dysfunction level.SPSS 26.0 data were used for statistical analysis,and the frequency and constituent ratio were used to describe the general data of patients;The mean ± standard deviation was used to describe the total scores and dimensions of the stigma experience questionnaire,body image scale and Arizona sexual experience scale;Pearson correlation analysis was used to analyze the relationship between stigma,body image and sexual dysfunction;One way ANOVA or t-test of independent samples were used to compare the differences between different sociodemographic characteristics and sexual dysfunction scale scores of breast cancer patients after operation.Amos 26.0 statistical software was used to verify the hypothetical model and analyze the mediating effect of stigma.Results:1.The total score of body image after breast cancer surgery was 11.23±4.11,including4.82±2.02 in emotional dimension,1.96±1.06 in behavioral dimension and 4.45±2.16 in cognitive dimension;The total score of shame was 26.57±7.51;The total score of sexual dysfunction was 21.73±3.26,including sexual drive dimension score of 4.26±0.93,sexual arousal dimension score of 4.33±0.88,vaginal lubrication dimension score of 4.25±0.86,orgasm dimension score of 4.39±0.79 and sexual satisfaction dimension score of 4.51±0.93.2.The results of difference analysis of different demographic variables showed that there were statistically significant differences between the levels of sexual dysfunction in patients with breast cancer after operation and those with different educational levels,different forms of medical expenses,different surgical methods,the first time of life after operation,and whether they had known about sex related knowledge(P < 0.05).3.Correlation analysis:There was a significant positive correlation between body image and sexual dysfunction(r = 0.346,P < 0.001);There was a significant positive correlation between stigma and sexual dysfunction(r = 0.485,P < 0.001);There was a significant positive correlation between body image and shame(r = 0.411,P < 0.001).4.The results of regression analysis showed that education level,operation method,body image score and shame score were the main predictors of sexual dysfunction score in patients with breast cancer after operation.5.The results of mediating effect analysis showed that the structural equation model was constructed with body image as the independent variable,stigma as the intermediary variable and sexual dysfunction as the dependent variable.The final model adaptation indexes were GFI = 0.903,RMSEA = 0.041,TLI = 0.953,IFI = 0.959,CFI = 0.958,CN = 350.794 and Cmin / DF = 1.482.The results of mediating effect showed that there was a partial mediating effect between body image and sexual dysfunction.The direct effect of body image on disease shame was 0.308,and the mediating effect of disease shame was 0.218,accounting for 41.4%of the total effect.Conclusion:The results showed that the stigma,body image and sexual dysfunction of breast cancer patients were at a moderate level.There are positive correlations between three aspects of stigma,body image and sexual dysfunction after breast cancer surgery.It preliminarily verified the intermediary role of stigma in body image and sexual dysfunction.The higher the level of body image and stigma,the higher the level of sexual dysfunction.Therefore,the medical staff need to pay close attention to the psychological problems of patients,help patients adjust their mental state after surgery,relieve the enormous psychological pressure of body image disorder and stigma caused by diseases and treatments,and formulate scientific and effective health education interventions to regulate the sexual health problems of breast cancer patients after operation.