Breaking the Silence: Psychological Abuse Among Patients with Breast Cancer

Background: Research on psychological abuse among patients with breast cancer and survivors of breast cancer in Saudi Arabia is scarce. This study aimed to identify psychological abuse and its associated factors among these individuals. Methods: This cross-sectional study included 146 patients with breast cancer and survivors of breast cancer. Data were collected from December 2024 to April 2025 using a modified survey instrument based on the United Nations Economic Commission for Europe violence against women module. An online questionnaire comprised two parts: the first collected demographic characteristics, including age, education, employment, breast cancer diagnosis, and mastectomy duration, and the second assessed psychological abuse via four items: insults, belittlement/humiliation, intimidation, and undermining of relationship stability. The association between psychological abuse and sociodemographic factors was assessed using the chi-square test. Significant associations in bivariate analyses were subsequently analyzed using exploratory logistic regression. Results: Approximately 20.5% of participants reported experiencing at least one form of psychological abuse. The most commonly reported behaviors were insults and undermining of relationship stability (both 20.5%), followed by belittlement/humiliation (17.8%) and intimidation (15.1%). Bivariate analyses indicated a greater incidence of humiliation among women whose spouses were unemployed or retired, as well as among those with more than six children. Logistic analysis indicated that spouse unemployment or retirement (OR = 5.36, 95% CI 1.62-17.74, p = 0.006) and having more than six children (OR = 5.84, 95% CI 1.33-25.55, p = 0.019) were associated with belittlement/humiliation, even after FDR correction. No significant correlations were identified regarding patient age, education, mastectomy status, or duration since diagnosis. Model diagnostics demonstrated a satisfactory fit (Nagelkerke R² = 0.22; accuracy = 82.2%) and a lack of multicollinearity (VIF = 1.00-1.03). Conclusions: Psychological abuse affects around 20% of women diagnosed with breast cancer, especially those with unemployed spouses and larger families. These results highlight the need for psychological screening and couple-based therapies in cancer care to mitigate marital stresses and enhance survivors' well-being.