{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:23:26Z","timestamp":1787289806328,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the heterogeneity of stress experiences, identify latent stressor profiles, and analyze their influencing factors in patients with breast cancer undergoing postoperative chemotherapy, in order to provide evidence for implementing precise psychosocial interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An explanatory sequential mixed-methods design was employed. A total of 232 patients with breast cancer undergoing postoperative chemotherapy at Nantong University Affiliated Hospital were conveniently sampled and participated in a cross-sectional survey using a general information questionnaire and the Chinese version of the Stressor Scale for Breast Cancer Patients. Latent profile analysis (LPA) was used to identify heterogeneous subgroups of stress experience, and multinomial logistic regression was conducted to analyze the influencing factors. Subsequently, 12 patients belonging to different stress profiles were purposively sampled for semi-structured interviews. Thematic analysis was performed on the interview transcripts using Colaizzi\u2019s phenomenological method to extract core themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The stress experiences of patients with breast cancer undergoing postoperative chemotherapy presented four distinct latent profiles: \u2018Low-stress Adaptive Profile\u2019 (26.3%), \u2018Moderate-High Physio-Psychological Distress Profile\u2019 (38.4%), \u2018High Medical Concerns Profile\u2019 (20.3%), and \u2018High-Stress Across Domains Profile\u2019 (15.1%). Multinomial logistic regression analysis revealed that older age was a protective factor. For each one-year increase in age, the risk of belonging to the \u2018Moderate-High Physio-Psychological Distress Profile\u2019 (OR\u00a0=\u00a00.94, 95%CI: 0.90-0.98) and the \u2018High-Stress Across Domains Profile\u2019 (OR\u00a0=\u00a00.91, 95% CI: 0.86-0.96) decreased. Advanced clinical stage (Stage III) was an independent risk factor for belonging to the \u2018High Medical Concerns Profile\u2019(OR=2.20, 95%CI: 1.02-4.75) and the \u2018High-Stress Across Domains Profile\u2019 (OR=4.80, 95%CI: 1.85-12.45). Furthermore, low monthly family income (\u22645000 RMB, OR\u00a0=\u00a03.50,95%CI: 1.25-9.80) and the presence of treatment-related complications(OR=2.80, 95%CI: 1.15-6.82)significantly increased the risk of belonging to the \u2018High-Stress Across Domains Profile\u2019. Qualitative interviews yielded three core themes: \u2018Intertwined and Impactful Multiple Stressors\u2019, \u2018Depletion and Dysregulation of Internal Psychological Resources\u2019, and the \u2018Double-Edged Sword Effect of External Support Systems\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The stress experiences of patients with breast cancer undergoing postoperative chemotherapy exhibit significant heterogeneity, with over 70% experiencing moderate to high levels of stress. Clinical practice should incorporate stress profile identification. Targeted support, such as enhanced information and decision-making aids for patients in the \u2018High Medical Concerns Profile\u2019 and multi-dimensional integrated interventions for those in the \u2018High-Stress Across Domains Profile\u2019, is recommended to achieve precise psychosocial support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1918956","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:31Z","timestamp":1787286211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of latent profiles of stressors and their influencing factors in patients with breast cancer undergoing postoperative chemotherapy: a mixed-methods study"],"prefix":"10.3389","volume":"16","author":[{"given":"Jingjing","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Oncology, Affiliated Hospital of Nantong University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Affiliated Hospital of Nantong University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Affiliated Hospital of Nantong University","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(25)00730-2","article-title":"Global, regional, and national burden of breast cancer among females, 1990\u20132023, with forecasts to 2050: a systematic analysis for the global burden of disease study 2023","volume":"27","author":"Bhangdia","year":"2026","journal-title":"Lancet Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"111045","DOI":"10.1016\/j.isci.2024.111045","article-title":"Global, reginal, national burden and risk factors in female breast cancer from 1990 to 2021","volume":"27","author":"Lan","year":"2024","journal-title":"Iscience"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102375","article-title":"Adjuvant and neoadjuvant breast cancer treatments: a systematic review of their effects on mortality","volume":"105","author":"Kerr","year":"2022","journal-title":"Cancer Treat Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2022.2151584","article-title":"Chemotherapy in patients with early breast cancer: clinical overview and management of long-term side effects","volume":"21","author":"Di Nardo","year":"2022","journal-title":"Expert Opin Drug Saf"},{"key":"B5","first-page":"1923","article-title":"Factors influencing psychological distress and effects of stepwise psychological care on quality of life in patients undergoing chemotherapy after breast cancer surgery","volume":"14","author":"Tu","year":"2022","journal-title":"Am J Transl Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12912-023-01184-1","article-title":"Depression, anxiety and stress among metastatic breast cancer patients on chemotherapy in china","volume":"22","author":"Guo","year":"2023","journal-title":"BMC Nurs"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/hnp.0000000000000580","article-title":"Mindfulness-based stress reduction for quality of life, psychological distress, and cognitive emotion regulation strategies in patients with breast cancer under early chemotherapy\u2014a randomized controlled trial","volume":"37","author":"Zhu","year":"2023","journal-title":"Holist Nurs Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1186\/s12905-023-02662-z","article-title":"Breast cancer treatment and recovery: pets\u2019 roles as emotional buffers and stressors","volume":"23","author":"Kogan","year":"2023","journal-title":"BMC Women's Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/s41523-024-00654-2","article-title":"Allostatic load as a predictor of postoperative complications in patients with breast cancer","volume":"10","author":"Chen","year":"2024","journal-title":"NPJ Breast Cancer"},{"key":"B10","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1080\/07347332.2025.2509983","article-title":"The relationships between marital support, partner participation, body image, and mental distress among bedouin women with breast cancer survivors","volume":"44","author":"Iris","year":"2026","journal-title":"J Psychosoc Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s40359-025-03741-6","article-title":"The effects of posttraumatic stress symptoms on anxiety and depression in patients with breast cancer: mediating role of negative interpretation bias","volume":"14","author":"Wang","year":"2026","journal-title":"BMC Psychol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.s537692","article-title":"Unveiling psychological capital profiles and their impact on quality of life in breast cancer patients: a latent profile analysis","author":"Cui","year":"2025","journal-title":"Cancer Manag Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2024.102652","article-title":"Body image, self-efficacy, and sleep quality among patients with breast cancer: a latent profile and mediation analysis","volume":"71","author":"Li","year":"2024","journal-title":"Eur J Oncol Nurs"},{"key":"B14","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s00520-025-09246-7","article-title":"Association among cognitive emotion regulation strategies, psychological flexibility and subjective well-being in patients with breast cancer: a cross-sectional latent profile and mediation analysis","volume":"33","author":"Zheng","year":"2025","journal-title":"Support Care Cancer"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1102169","article-title":"Development and psychometric properties of the stressors in breast cancer scale","volume":"14","author":"Cerezo","year":"2023","journal-title":"Front Psychol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"195","DOI":"10.32768\/abc.202292195-203","article-title":"Effectiveness of positive thinking training on perceived stress, metacognitive beliefs, and death anxiety in women with breast cancer: perceived stress in women with breast cancer","author":"Barjoee","year":"2022","journal-title":"Arch Breast Cancer"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/978-981-97-2085-9_39","article-title":"Stress and coping theory","author":"Biggs","year":"2025"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.12102\/j.issn.1009-6493.2025.10.010","article-title":"To translate the Breast Cancer Patient Stressor Scale into Chinese and test its reliability and validity","volume":"39","author":"Jiang","year":"2025","journal-title":"Nurs Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1525822x05282260","article-title":"Using mixed-methods sequential explanatory design: from theory to practice","volume":"18","author":"Ivankova","year":"2006","journal-title":"Field Method"},{"key":"B20","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s11764-023-01336-x","article-title":"Psychosocial experiences of breast cancer survivors: a meta-review","volume":"18","author":"King","year":"2024","journal-title":"J Cancer Surviv"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2794408","article-title":"Investigation of factors influencing the fear of cancer recurrence in breast cancer patients using structural equation modeling: a cross\u2010sectional study","volume":"2022","author":"Guo","year":"2022","journal-title":"Int J Clin Pract"},{"key":"B22","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1186\/s12885-021-09081-z","article-title":"The benefits and acceptability of virtual reality interventions for women with metastatic breast cancer in their homes; A pilot randomised trial","volume":"22","author":"Reynolds","year":"2022","journal-title":"BMC Cancer"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-024-01639-7","article-title":"Finding my tribe: a qualitative interview study of how people living with metastatic breast cancer perceive support groups","volume":"20","author":"Mackie","year":"2026","journal-title":"J Cancer Surviv"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70065","article-title":"Post\u2010treatment cancer survivors' experience of social reintegration: a systematic review and meta\u2010synthesis","volume":"34","author":"Ruan","year":"2025","journal-title":"Psycho\u2010Oncology"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15475","article-title":"Relationship between cancer stigma, social support, coping strategies and psychosocial adjustment among breast cancer survivors","volume":"29","author":"Kang","year":"2020","journal-title":"J Clin Nurs"},{"key":"B26","doi-asserted-by":"publisher","first-page":"465","DOI":"10.21203\/rs.3.rs-5643052\/v1","article-title":"A systematic review on the effects of logotherapy and meaning-centered therapy on psychological and existential symptoms in women with breast and gynecological cancer","volume":"33","author":"Aiello-Puchol","year":"2025","journal-title":"Support Care Cancer"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000001262","article-title":"Financial toxicity among breast cancer patients: a scoping review of risk factors and outcomes","volume":"48","author":"Kuang","year":"2025","journal-title":"Cancer Nurs"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1200\/edbk-25-473450","article-title":"Financial toxicity and breast cancer: why does it matter, who is at risk, and how do we intervene","volume":"45","author":"Lee","year":"2025","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1186\/s12885-023-11576-w","article-title":"Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion","volume":"23","author":"Fauser","year":"2023","journal-title":"BMC Cancer"},{"key":"B30","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.ejso.2021.09.007","article-title":"Impact of neoadjuvant chemotherapy on surgical complications in breast cancer: a systematic review and meta-analysis","volume":"48","author":"Lorentzen","year":"2022","journal-title":"Eur J Surg Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-07494-5","article-title":"Effectiveness of three exercise programs and intensive follow-up in improving quality of life, pain, and lymphedema among breast cancer survivors: a randomized, controlled 6-month trial","volume":"31","author":"Lin","year":"2023","journal-title":"Support Care Cancer"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-026-58016-w","article-title":"Stress and risk of breast cancer; findings from a large population-based incident case-control study","author":"Yazdi","year":"2026","journal-title":"Sci Rep"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1918956\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:33Z","timestamp":1787286213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1918956\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":32,"alternative-id":["10.3389\/fonc.2026.1918956"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1918956","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1918956"}}