The Mediating Role of Mental Adjustment in Relationships between Cognitive Processing, with Post-Traumatic Stress Symptoms and Fear of Cancer Recurrence, in Patient with Cancer

Introduction: The purpose of this study was to investigate the mediating role of mental adjustment in the relationship between cognitive processing with post-traumatic stress symptoms and fear of recurrence in patients with cancer. Method: This is a cross-sectional study with a convenience sampling method. A total of 200 women and man with one of the types of cancer (breast, blood and gastrointestinal) in Tehran, Iran participated in this study and completed five questionnaires, namely the PTSD checklist, fear of cancer recurrence scale, and mental adjustment to cancer scale. The findings were analyzed through the advanced statistical method of structural equation modeling and using SPSS26 and SmartPLS 4 software Findings: Structural Equation Modelling demonstrated that cognitive processing was negatively associated with PTSD (β= -.473; T=11.84; P<.001) and fear of recurrence (β= -.462; T=10.52; P<.001), also mental adjustment was negatively associated with PTSD (β= -.496; T=11.84; P<.001), and fear of recurrence (β= -.462; T=10.52; P<.001), and cognitive processing were positively associated with mental adjustment (β=.753; T=34.52; P<.001).Bootstrapping analysis showed that mental adjustment acted as a mediator between cognitive processing and PTSD, and cognitive processing and fear of recurrence. Conclusion: In general, the findings emphasized the important role of cancer-related cognitive impairment in the possible consequences of this disease.