Predicting Avoidance Strategies Based on General Concerns and Sleep Quality in Patients with Breast Cancer: the Mediating Role of Loneliness

Avoidance behaviors increase in women with cancer as they feel more alone. On the other hand, these patients feel more concern about their health and their sleep quality decreases. Therefore, the aim of this study was to investigate avoidance strategies based on general concerns and sleep quality in patients with breast cancer with a mediating role of loneliness.

In this descriptive correlational study, 286 patients with breast cancer referred to public and private centers in Tehran and Alborz provinces were selected to participate in the study. Samples were selected by available sampling methods. Participants then completed the Cancer-Related Loneliness Scale, the General Concern Scale, the Pittsburgh Sleep Quality Index, and the Avoidance Strategy. The research data were analyzed using SPSS-23 and LISREL statistical software through confirmatory test, path analysis, and Pearson correlation.

The results showed that cancer-related loneliness and avoidance strategy had a significant relationship with sleep quality and general concerns in patients with breast cancer (p<0.05). In addition, the results of path analysis showed that, avoidance strategies had a direct impact on general concerns and sleep quality, and cancer-related loneliness had indirect effect on sleep quality (p<0.05). At the same time, cancer-related loneliness failed to mediate the link between avoidance strategies and public concerns.

It can be said that avoidance strategies have a direct impact on the general concern and sleep quality of cancer patients. Also, the feeling of loneliness had a direct effect on the sleep quality of breast cancer patients. Therefore, by improving avoidance strategies, the sleep quality of these patients can be improved and their level of anxiety reduced.