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Dual Mediating and Moderating Roles of Hope in the Association Between Marital Satisfaction and Post-Traumatic Growth
Zhi Hui Gu1, Ji Xiang Bao1, Yang Tan1
1Department of Social Medicine, School of Health Management, China Medical University, Shenyang, People's Republic of China.
Purpose:
This study aimed to identify latent profiles of post-traumatic growth (PTG) among Chinese breast cancer patients and to explore the dual mediating and moderating roles of hope in the association between marital satisfaction (MS) and PTG, so as to clarify the psychological mechanism underlying marital relationship and positive psychological adaptation after cancer.
Patients And Methods:
A cross-sectional survey was conducted on 421 breast cancer patients from the Breast Surgery Department of Anshan Cancer Hospital, Liaoning, China. Participants completed the Herth Hope Index, Marital Adjustment Scale, and Post-traumatic Growth Inventory. Latent profile analysis (LPA) was used to classify PTG sub-types; hierarchical regression, bootstrap resampling and simple slope tests were applied to examine the mediating and moderating effects. Statistical analyses were performed using Mplus 8.3 and IBM SPSS 26.0.
Results:
Three latent PTG subgroups were identified: PTG-resistance (20.5%), PTG-slow growth (27.6%), and PTG-healthy growth (51.9%). Hope exerted a partial mediating effect on the relationship between MS and PTG, accounting for 29.5% of the total effect. Also, hope significantly moderated this association and served as a weakening moderator (ΔR2=0.139, P<0.001). The positive linkage stronger among those with lower hope levels. Patients with high hope relied less on marital relationship quality to achieve positive psychological growth and maintained stable PTG independently.
Conclusion:
Hope acts as both partial mediator and weakening moderator. Low-hope patients are more affected by MS, whereas high-hope patients maintain steady PTG via internal psychological resources. This PTG sub-type classification combined with hope-related psychological mechanisms facilitates targeted and individualized psychological intervention strategies for breast cancer patients.
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