{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:14:02Z","timestamp":1788160442871,"version":"build-2803163510"},"reference-count":63,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":241,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515012192"],"award-info":[{"award-number":["2022A1515012192"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2025A1515010750"],"award-info":[{"award-number":["2025A1515010750"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013153","name":"Shantou Science and Technology Project","doi-asserted-by":"publisher","award":["250804096497979"],"award-info":[{"award-number":["250804096497979"]}],"id":[{"id":"10.13039\/501100013153","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Breast Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast cancer comprehensive therapies often cause body image changes, triggering stigma that impairs mental health and quality of life. Existing studies lack an integrated model to reveal the underlying mechanisms between these variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey was conducted among 292 breast cancer patients selected via convenience sampling from 5 hospitals in Guangdong Province between March 2021 and March 2022. The Distress Disclosure Index (DDI), Consumer Experiences of Shame Questionnaire (CESQ), Functional Assessment of Cancer Therapy\u2010Breast (FACT\u2010B), and Multidimensional Scale of Perceived Social Support (PSSS) scales were administered. Pearson correlation analysis explored variable relationships, structural equation modeling (SEM) constructed the chain mediating model, the Bootstrap method tested mediating effects, and subgroup associations with stigma were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Breast cancer patients had self\u2010disclosure and stigma scores of 38.17\u2009\u00b1\u20090.54 and 13.74\u2009\u00b1\u20090.42, respectively. Stigma was significantly negatively correlated with self\u2010disclosure, social support, and quality of life (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). Self\u2010disclosure was directly associated with lower stigma (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.52,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and indirectly mediated by two pathways: the independent pathway through \u201cbetter quality of life\u201d (11.6% of total effect) and the chain pathway through \u201chigher social support and better quality of life\u201d (5.4% of total effect). Subgroup analysis indicated that patients with a bachelor\u2019s degree or above were more significantly associated with low stigma (OR\u2009=\u20090.42, 95% CI: 0.17\u20130.96), while introverted patients showed a stronger association with high stigma than extroverted ones (OR\u2009=\u20092.90, 95% CI: 1.57\u20135.56).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breast cancer patients exhibit relatively low self\u2010disclosure and moderate\u2010to\u2010low stigma. Higher self\u2010disclosure is associated with lower stigma directly or indirectly via the chain mediation of social support and quality of life. Enhancing psychological counseling, social support, and quality of life, paired with targeted interventions for education and personality subgroups, facilitates physical and mental recovery and social reintegration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/tbj\/8826025","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:22:46Z","timestamp":1788157366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on the Pathway Mechanism of Social Support and Quality of Life Between Self\u2010Disclosure and Stigma Among Breast Cancer Patients During Recovery"],"prefix":"10.1155","volume":"2026","author":[{"given":"Siyin","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beien","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4180-8931","authenticated-orcid":false,"given":"Jiaxing","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongtao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5864-7948","authenticated-orcid":false,"given":"Guanhua","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00730-2"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.85398"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2023.100293"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5590"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00747-5"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.5152\/FNJN.2021.19098"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-07506-4"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000373"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1075298"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-020-03136-7"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31709-X"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70021"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2024.25.11.3781"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.25215\/1104.275"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-9004.2007.00013.x"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2025.100592"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-023-08255-8"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/clipsy.9.1.35"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2021.02.014"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1365246"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.19082\/5212"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12443"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2022.2056877"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-025-02357-z"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.98.2.310"},{"key":"e_1_2_15_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/14796694.2024.2370237"},{"key":"e_1_2_15_27_2","first-page":"1603","article-title":"The 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