The mediating role of fatigue in relationships between Cognitive Control with Post-Traumatic Stress Symptoms, and Adherence to treatment in Patient with Breast Cance

Breast cancer (BC) is the most common cancer diagnosed in women in worldwide. This study examines the mediating role of fatigue in relationships between cognitive control with post-traumatic stress symptoms, and adherence to treatment in patient with breast cancer.

This is a cross-sectional study with a convenience sampling method. A total of 206 women with breast cancer in Karaj, Iran participated in this study and completed five questionnaires, namely the PTSD checklist, the Adult Executive Functioning Inventory, the cognitive flexibility scale, the cancer fatigue scale, and the treatment adherence Inventory. The findings were analyzed through the advanced statistical method of structural equation modeling and using SPSS26 and SmartPLS 4 software

Structural Equation Modelling demonstrated that cognitive control was positively associated with PTSD (β= .598; T=3.76; P<.001) and fatigue (β= .829; T=19.17; P<.001), also fatigue was positively associated with PTSD (β= .389; T=2.38; P=.02). The results showed a non-significant relationship between cognitive control and fatigue (β= .23; T=1.29; P=.21) and cognitive control with adherence to treatment (β= .01; T=.09; P=.93). Multiple mediator modeling provided evidence that fatigue partially mediated the relationship between cognitive control and PTSD, and a full mediated relationship between cognitive control and treatment adherence.

In general, the findings emphasized the important role of cancer-related cognitive impairment in the possible consequences of this disease. An important issue that, along with other problems such as fatigue, can affect the quality of life and mental health of breast cancer patients.