The chain mediating effects of psychological capital and illness perception on the association between social support and acceptance of illness among Chinese breast cancer patients: A cross-sectional study

Purpose: Acceptance of illness is crucial for effective breast cancer management and better health outcomes. Although social support is known to aid illness acceptance, the underlying mechanisms remain unclear. This study aims to examine the chain mediating role of psychological capital and illness perception in the relationship between social support and acceptance of illness among Chinese breast cancer patients. Methods: 239 breast cancer patients from a major public hospital in Henan Province were recruited to complete the general information questionnaire, the Acceptance of Illness Scale, the Perceived Social Support Scale, the Positive Psychological Capital Questionnaire, and the Brief Illness Perception Questionnaire. Data were analyzed using SPSS26.0 and PROCESS Macro. Results: Social support, psychological capital, and illness perception had direct and statistically significant correlations with acceptance of illness (P < 0.01). The mediation model revealed that social support indirectly impacted acceptance of illness through three distinct pathways: the independent mediating effect of psychological capital (beta = 0.146, 95% confidence interval (CI) [0.086, 0.206]), the independent mediating effect of illness perception (beta = 0.120, 95% CI [0.062, 0.184]), and the chain mediating effect of psychological capital and illness perception (beta = 0.210, 95% CI [0.155, 0.272]). These indirect effects accounted for 20.80%, 17.09%, and 29.91% of the total effect, respectively. Conclusions: This study underscores the chain mediating effects of psychological capital and illness perception in the relationship between social support and acceptance of illness in Chinese breast cancer patients. Enhancing social support, strengthening psychological capital, and addressing negative illness perceptions can effectively improve acceptance of illness.