Yingjie Cai

Aim To establish a chain mediating model examining family caring, illness acceptance, perceived control, and self-perceived burden, based on the middle-range theory of adaptation to chronic illness, and to empirically test this model. Methods From June 2023 and March 2024, 254 elderly breast cancer patients were enrolled. Data were collected using a general information questionnaire, the family APGAR questionnaire, the self-perceived burden scale for breast cancer patients, the acceptance of illness scale, and the cancer experience and efficacy scale. IBM SPSS v26.0 and IBM AMOS v26.0 were used for data analysis. Results Family caring, illness acceptance, and perceived control demonstrated direct and statistically significant associations with self-perceived burden. Family caring indirectly affected self-perceived burden through five identified pathways. Three served as independent partial mediators in the relationship between family caring and self-perceived burden: illness acceptance (β = -0.172, [-0.110, -0.042]), perceived control (cancer experience) (β = -0.115, [-0.183, -0.056]), and perceived control (control efficacy) (β = -0.136, [-0.182, -0.098]). Two others were serial mediation pathways in the relationship: one through illness acceptance and perceived control (cancer experience) (β = 0.046, [0.016, 0.088]), and another through illness acceptance and perceived control (control efficacy) (β = 0.029, [0.013, 0.052]). Conclusions and Implications for Cancer Survivors The study confirmed that family caring primarily alleviates self-perceived burden by enhancing illness acceptance and reducing negative cancer-related experiences in elderly breast cancer patients. Thus, the assessment of family caring should be integrated into routine nursing practice, and psychoeducational programs designed to promote illness acceptance and reduce negative cancer-related experiences should be implemented.