Association between stigma and sleep quality in patients with breast cancer: A latent profile and mediation analysis

Purpose: This study aims to identify the heterogeneity in the stigma experienced by patients with breast cancer and examine the mediation effect of resilience on the relation between stigma and sleep quality.Method: A total of 396 patients with breast cancer were enrolled from Be Resilient to Breast Cancer (BRBC) program between January and April 2023. Participants completed the Social Impact Scale, the 10-item Connor-Davidson Resilience Scale, and the Pittsburgh Sleep Quality Index Scale. Latent profile analysis (LPA) and mediation analysis were conducted to analyze the data.Results: LPA categorized stigma into three subgroups, namely low-stigma (21.9%), moderate-stigma (64.9%), and high-stigma (13.2%). Mediation analysis revealed a fully mediated effect in the comparison between low-stigma and moderate-stigma groups (standard error [SE] = 0.13, 95%CI = 0.06,0.56), whereas a partially mediated effect was observed in the comparison between low-stigma and high-stigma groups (SE = 0.18, 95%CI = 0.39,1.10).Conclusions: Stigma is a significant factor to sleep quality in breast cancer and resilience could act as a robust buffer against stigma resulting in improved sleep quality. Resilience-based interventions might be helpful in this population.