Social Avoidance Trajectories, Core Characteristics and Maintenance Factors in Postoperative Breast Cancer Patients: A Longitudinal Mixed‐Methods Study

ABSTRACT

Aim

To examine the trajectories, core characteristics, and maintenance factors of social avoidance in patients with breast cancer during the first postoperative year.

Design

Longitudinal, explanatory sequential mixed-method design.

Methods

This longitudinal study enrolled 176 postoperative breast cancer patients, conducting six follow-up assessments over 1 year. Latent class growth analysis was employed to identify heterogeneous trajectories of social avoidance behaviour, with multivariate logistic regression subsequently analyzing predictive factors. Building on these quantitative findings, semi-structured in-depth interviews were administered to target individuals identified through the analysis. Phenomenological methods were then utilized to elucidate core manifestations and maintenance factors of social avoidance.

Results

Among the 176 enrolled breast cancer patients, 138 completed all six follow-up assessments. Latent class growth analysis identified two distinct subgroups with significant differences in social avoidance trajectories: ‘persistent high social avoidance’ and ‘persistent low social avoidance group’. Logistic regression revealed melancholic temperament as an independent risk factor for ‘persistent high social avoidance group’, while choleric temperament demonstrated protective effects. Phenomenological analysis of qualitative data systematically identified four core themes: (1) affective manifestations, (2) behavioural patterns, (3) psychological drivers, and (4) environmental determinants of social avoidance.

Conclusion

This study revealed heterogeneous dynamic trajectories of social avoidance behaviour in breast cancer patients, with core manifestations encompassing both affective and behavioural dimensions, sustained by multiple factors of personality, psychology, and environment.

Impact

This mixed-methods study systematically examined the developmental trajectories, core manifestations, and sustaining factors of social avoidance behaviour in breast cancer patients. The results provide robust evidence to inform precision screening for social avoidance risk, early prevention initiatives, and tailored intervention strategies in clinical nursing practice.

Reporting Method

Journal article reporting standards for mixed-methods research.

Patient or Public Contribution

No patient or public contribution.