Coping strategies & benefit-finding in the relationship between non-disclosure & depressive symptoms among breast cancer survivors in China

Objective: Open communication about cancer diagnosis and relevant stress is frequently avoided among breast cancer survivors in China. Non-disclosure behavior may lead to negative psychological consequences. We aimed to examine the relationship between non-disclosure and depressive symptoms, and the role of coping strategies and benefit-finding in that relationship among Chinese breast cancer survivors. Methods: Using convenience sampling, we recruited 148 women in an early survivorship phase (up to 6 years post-Treatment) in Nanjing, China. Participants were asked to complete a set of questionnaires in Chinese language, regarding sociodemographic characteristics, depressive symptoms, disclosure views, coping strategies, and benefit-finding. Results: A higher level of non-disclosure was associated with more depressive symptoms. This relationship was mediated by self-blame and moderated by benefit-finding. Specifically, nondisclosure was associated with depressive symptoms through self-blame. The impact of non-disclosure was minimized among the women with a higher level of benefit-finding. Conclusion: Unexpressed cancer-related concern may increase selfblame, which leads to emotional distress among Chinese breast cancer survivors. Practicing benefit-finding may reduce the negative impact of non-disclosure. As a culturally appropriate way of disclosure, written expression may be beneficial to Chinese breast cancer patients.