Abstract
PURPOSE: Middle-aged and older individuals are at a crucial stage of aging, marked by increased vulnerability to psychological and physiological challenges. Cancer has a negative impact on the quality of life of patients. Stigma is closely related to the quality of life (QoL) of middle-aged and older patients with malignant gynecological tumors, but the mechanism behind this relationship is still unclear. Sense of coherence (SOC) and psychological resilience (PR) are positive mental health factors that can alleviate psychological stress and improve the quality of life. Therefore, this study aimed to explore the mediating role of sense of coherence and psychological resilience between stigma and quality of life. METHODS: A cross-sectional survey was conducted from May 2023 to January 2024, involving a total of 428 postoperative patients from the gynecological oncology departments of four tertiary grade A hospitals in Fujian Province. Assessment tools included the Functional Assessment of Cancer Therapy-General scale, the Social Impact Scale, the Connor-Davidson Resilience Scale, and the Sense of Coherence Scale-13. Data analysis was performed using IBM SPSS 26.0 and AMOS 24.0 software. RESULTS: Descriptive analyses showed generally low quality of life levels. Stigma negatively affected psychological resilience and quality of life, while psychological resilience positively affected quality of life. Stigma also negatively influenced the sense of coherence, whereas the sense of coherence positively affected quality of life. Furthermore, the sense of coherence had a positive effect on psychological resilience. The sense of coherence and psychological resilience partially mediated the relationship between stigma and quality of life. CONCLUSIONS: Stigma has a direct impact on the quality of life and also exerts an indirect effect through the mediation of sense of coherence and psychological resilience. Clinical healthcare providers can improve patients' quality of life by reducing stigma and promoting sense of coherence and psychological resilience.