[A study on self-compassion and stigmatisation in female patients with breast cancer]

Background: The number of patients with cancer is increasing rapidly: in only one year, in 2020 19.3 million new cases were registered and as many as 10 million deaths occurred due to tumours worldwide. Shame and self-blame for developing cancer deteriorate patients' quality of life and correlate significantly with poor adaptation and physical health, consequently may be risk factors in the final negative outcome. It is proven that stigmatisation may cause torturing emotional symptoms like shame leading to depressive symptoms, which, in turn, may deteriorate the patient's capacity to cope and her well-being, thus growing the risk of mortality. For all the above, a high level of self-compassion may be a potential solution. Numerous studies have already proven that self-compassion may significantly decrease the level of shame, depression, frustration as well as the perception of being stigmatised while resulting in a measurably better quality of life. The purpose of the investigation was to point out the relationship between shame, stigmatisation, depression on the one hand, and selfcompassion on the other while providing support for the effectiveness of self-compassionbased interventions among female breast cancer patients. Methods: The present study is part of the fi rst phase of a translational research, in other words it is part of a basic research already carried out. This cross-sectional study collected data using online questionnaires based on self-reports with female breast cancer patients aged between 18 and 45, who had been diagnosed in the past two years and did not present with distant metastases (n=79, mean age: 39.05 years, SD= 7.37). To measure constructs standardised scales were applied including the Experience of Shame Scale (ESS), the Stigma Scale for Chronic Illnesses 8-item version (SSCI8), the Hospital Anxiety and Depression Scale (HADS) and the Self-Compassion Scale (SCS). The research hypotheses were tested by hierarchic regression, correlation, and mediation analyses. Results: Stigmatisation shows a positive and strong (r = 0.56, p < 0.01) relationship with physical shame while self-compassion has a negative and strong relationship with the same (r = 0.71, p < 0.01). Hierarchical regression revealed that self-compassion was the only predictive factor in female breast cancer patients regarding physical shame (β = - 0.09, p < 0.001) after controlling for age, marital status, exposure to operation, stigmatisation, and depression. According to mediation models a higher level of stigmatisation may result in a more expressed feeling of shame and depression through a lower level of self-compassion. We found a full mediation between shame and depression, which means that shame causes a higher level of depression entirely indirectly, through a decrease in self-compassion. Conclusions: The results of this work highlight the expected effectiveness of developing self-compassion in terms of alleviating shame, stigmatisation, and depression, thus contributing to a better quality of life among cancer patients. The main purpose of the translational research that was the basis of the present study was to develop a complex cognitive therapeutic programme that would, in a gap-filling way, offer oncological patients an effective psychological intervention supported by investigation. The results of the present study prove beyond doubt the rationale of the programme and involve the basic elaboration of a significant psycho-oncological practice.