The Relationship between Emotion Regulation and Fear of Relapse with the Level of Acceptance of Cancer in Women after Mastectomy

Abstrakt

Objective of the study: Breast cancer is the most frequently diagnosed malignancy among women in Poland, and it also significantly impacts their psychological functioning. This article aims to examine the relationships between selected emotion regulation strategies, fear of disease recurrence, and the level of acceptance of the illness in women after mastectomy. Method: The study involved 150 Polish women after mastectomy, aged 22 to 73 (M = 44.67, SD = 8.11), and was conducted using an electronic questionnaire. A set of standardized psychometric tools was used in the study: the Interpersonal Emotion Regulation Questionnaire (IERQ), the Cancer Worry Scale (CWS), and the Acceptance of Life with Illness Scale (ALS) to measure emotion regulation, fear of disease recurrence, and the level of acceptance of illness. Statistical analyses included Pearson’s r correlation, stepwise regression, and cluster analysis. Results: The results showed that social modeling demonstrated a positive association with acceptance of illness, but smoothing, contrary to assumptions, was negatively associated with coming to terms with the illness. Fear of relapse showed a significantly negative correlation with satisfaction with life despite the disease. Fear of relapse is the most important negative predictor of acceptance of illness – it reduces satisfaction with life despite illness, and distancing oneself from the disease. Social modeling is a positive predictor of acceptance of disease, but soothing, although seemingly adaptive, was associated with lower levels of acceptance of illness – likely a manifestation of emotional withdrawal. Conclusion: The study’s results confirm that the process of psychological adaptation to the disease is not one-dimensional but depends on many factors – both individual and environmental. At the same time, they provide important information that may be helpful in disease acceptance among women after mastectomy.

Bibliografia

Basińska, M. A., & Woźniewicz, A. (2012). Inteligencja emocjonalna chorych na łuszczycę jako wyznacznik akceptacji choroby [Emotional intelligence of psoriasis patients as a determinant of disease acceptance]. Przegląd Der-matologiczny, 99(4), 202–209.

Bergerot, C., Bergerot, P. G., Maués, J., Segarra-Vazquez, B., Mano, M. S., & Tarantino, P. (2024). Is cancer back? – Psychological issues faced by sur-vivors of breast cancer. Annals of Palliative Medicine, 13(5), 1229–1234. https://doi.org/10.21037/apm-24-54

Brzeziński, J. (1999). O wymaganiach (nie tylko prawnych) stawianych prze-wodom doktorskim w zakresie psychologii [About the requirements (not only legal) for doctoral dissertations in psychology]. Przegląd psycholog-iczny, 42(4), 187–193.

Custers, J. A., van den Berg, S. W., van Laarhoven, H. W., Bleiker, E. M., Gielissen, M. F., & Prins, J. B. (2014). The Cancer Worry Scale: Detecting fear of recurrence in breast cancer survivors. Cancer Nursing, 37(1), E44–E50. https://doi.org/10.1097/NCC.0b013e3182813a17

Dryhinicz, M., & Rzepa, T. (2018). Poziom lęku, akceptacja choroby i radzenie sobie ze stresem przez pacjentki onkologiczne i nieonkologiczne [Anxiety levels, acceptance of illness and coping with stress among oncological and non-oncological patients]. Annales Universitatis Mariae Cu-rie-Skłodowska, Sectio J – Paedagogia-Psychologia, 31(1), 7–21.

Dziukiewicz, J. (2020). Mastektomia i co dalej? Funkcjonowanie kobiet po leczeniu choroby nowotworowej [Mastectomy and What Next? Women’s Functioning After Cancer Treatment]. Niepełnosprawność, 38, 141–154.

Eisenberg, N., Fabes, R., Guthrie, I., & Reiser, M. (2000). Dispositional emo-tionality and regulation: Their role in predicting quality of social function-ing. Journal of Personality and Social Psychology, 78(1), 136–157.

Gross, J. J. (1999). Emotion regulation: Past, present, future. Cognition and Emotion, 13(5), 551–573.

Grzywna, N., Filipiak, K., Nowak, K., Buczel, K., & Szpitalak, M. (2020). Kwes-tionariusz Interpersonalnej Regulacji Emocji (KIRE): Adaptacja do warunków polskich, struktura czynnikowa i wartości psychometryczne kwestionariusza Interpersonal Emotion Regulation Questionnaire (IERQ). In K. Nowak, K. Buczel & M. Szpitalak (Eds.), Społeczeństwo i media: Analiza wybranych zagadnień (pp. 269–286). Wydawnictwo Naukowe TYGIEL.

Guo, S., Cui, P., Wang, P., Liu, W., Shao, M., Li, T., & Chen, C. (2025). The chain mediating effects of psychological capital and illness perception on the association between social support and acceptance of illness among Chi-nese breast cancer patients: A cross sectional study. European Journal of Oncology Nursing, 75, 102800. https://doi.org/10.1016/j.ejon.2025.102800

Hofmann, S. G., Carpenter, J. K., & Curtiss, J. (2016). Interpersonal Emotion Regulation Questionnaire (IERQ): Scale development and psychometric characteristics. Cognitive Therapy and Research, 40(3), 341–356. https://doi.org/10.1007/s10608-016-9756-2

Janowski, K., & Biedrycka, M. (2014). Skuteczność psychoterapii Gestalt w zakresie regulacji emocji u pacjentów z zaburzeniami nerwicowy-mi/lękowymi [The effectiveness of Gestalt psychotherapy in emotion reg-ulation in patients with neurotic/anxiety disorders]. Psychoterapia, 171(4), 63–75. https://doi.org/10.12740/pt/30926

Janowski, K., Steuden, S. (2018). Skala Akceptacji Życia z Chorobą: narzędzie pomiaru ważnego wskaźnika przystosowania psychologicznego u osób z przewlekłą chorobą. Wykład wygłoszony podczas XXIII Ogólnopolskiej Konferencji Psychosomatycznej [The Acceptance of Life with Illness Scale: a tool for measuring an important indicator of psychological adjustment in people with chronic illness. Lecture delivered at the 23rd National Psy-chosomatic Conference]. Aktywnie przeciw problemom psychoso-matycznym. Uniwersytet Gdański, 12–13 maja 2018.

Janowski, K., Steuden, S., Pietrzak, A., Krasowska, D., Kaczmarek, Ł., Gradus, I., & Chodorowska, G. (2012). Social support and adaptation to the disease in men and women with psoriasis. Archives of Dermatological Research, 304(5), 421–432. https://doi.org/10.1007/s00403-012-1235-3

Kozińska, B. (2013). Przywiązanie a strategie przystosowania psychicznego do choroby nowotworowej w grupie kobiet z rakiem piersi [Attachment and strategies of psychological adaptation to cancer in a group of women with breast cancer]. Psychoonkologia, 17(1), 1–9.

Krok, D., Telka, E., & Kocur, D. (2024a). Perceived and received social support and illness acceptance among breast cancer patients: The serial mediation of meaning-making and fear of recurrence. Annals of Behavioral Medicine, 58(3), 147–155. https://doi.org/10.1093/abm/kaad067

Krok, D., Telka, E., & Moroń, M. (2023). Marital satisfaction, partner commu-nication, and illness acceptance among couples coping with breast cancer: A dyadic approach. Psycho-Oncology, 32(8), 1240–1247. https://doi.org/10.1002/pon.6174

Krok, D., Telka, E., & Moroń, M. (2024b). Personal resources and total pain: Exploring the multiple mediation of fear of recurrence, meaning-making, and coping in posttreatment cancer patients. Annals of Behavioral Medi-cine, 58(10), 692–700. https://doi.org/10.1093/abm/kaae029

Krok, D., Telka, E., & Zarzycka, B. (2022). Total pain and illness acceptance in pelvic cancer patients: Exploring self-efficacy and stress in a moderated mediation model. International Journal of Environmental Research and Public Health, 19(15), 9631. https://doi.org/10.3390/ijerph19159631

Krok-Schoen, J. L., Naughton, M. J., Bernardo, B. M., Young, G. S., & Paskett, E. D. (2018). Fear of recurrence among older breast, ovarian, en-dometrial, and colorectal cancer survivors: Findings from the WHI LILAC study. Psycho-Oncology, 27(7), 1810–1815. https://doi.org/10.1002/pon.4731

Kulpa, M., Kosowicz, M., Ziętalewicz, U., Stypuła-Ciuba, B., & Sosnowski, R. (2017). Psychological adaptation to cancer: Emotional and cognitive con-trol in patients with genitourinary system cancer. Medycyna Paliatywna, 9(1), 30–34.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

Lebel, S., Beattie, S., Arès, I., & Bielajew, C. (2013). Young and worried: Age and fear of recurrence in breast cancer survivors. Health Psychology, 32(6), 695–705. https://doi.org/10.1037/a0030186

Mieszkowski, J. P., Pastwik, M., Stejbach, K., Przybyłowicz, M., & Pijankow-ska, E. (2015). Kompleksowe postępowanie lecznicze nowotworów gruczołu sutkowego [Comprehensive treatment of mammary gland can-cer]. Journal of Education, Health and Sport, 5(7), 314–342. https://doi.org/10.5281/zenodo.20068

Ogińska-Bulik, N., & Kozak, G. (2002). Akceptacja choroby jako wyznacznik radzenia sobie z chorobą nowotworową u pacjentów opieki paliatywnej [Acceptance of the disease as a determinant of coping with cancer in pal-liative care patients]. Psychoonkologia, 6(1), 21–25.

Rocławska, A. R. (2015). Ocena jakości życia kobiet po mastektomii. Psy-choonkologia, 19(3), 116–124. https://doi.org/10.5114/pson.2015.57171

Sebri, V., Policardo, G. R., & Pravettoni, G. (2024). How to improve emotional regulation in breast cancer survivors? A psychological intervention. Fron-tiers in Psychology, 15, 1443635. https://doi.org/10.3389/fpsyg.2024.1443635

Simard, S., Thewes, B., Humphris, G., Dixon, M., Hayden, C., Mireskandari, S., & Ozakinci, G. (2013). Fear of cancer recurrence in adult cancer survivors: A systematic review of quantitative studies. Journal of Cancer Survivorship, 7(3), 300–322. https://doi.org/10.1007/s11764-013-0272-z

Thompson, R. A. (2019). Emotion dysregulation: A theme in search of defini-tion. Development and Psychopathology, 31(3), 805–815. https://doi.org/10.1017/S0954579419000282

Wojciechowska, U., Barańska, K., Miklewska, M., & Didkowska, J. (2023). Can-cer incidence and mortality in Poland in 2020. Nowotwory. Journal of On-cology, 73(3), 129–145. https://doi.org/10.5603/njo.99065

Załuski, M. (2016). Skala ruminacji: Opis kwestionariusza i wstępna analiza psychometryczna [Rumination Scale: Description of the questionnaire and preliminary psychometric analysis]. Problemy Pielęgniarstwa, 24(1), 55–60.

Opublikowane
2026-06-23
Dział
Zdrowie psychiczne, dobrostan psychiczny i religijność