Structural model of self-conscious emotions and health-related quality of life in non-metastatic breast cancer women: The mediating role of body image psychological inflexibility and self-compassion

Breast cancer profoundly impacts physical and psychological well-being, yet the role of self-conscious emotions in health-related quality of life (HRQoL) and body image remains underexplored. This study examined the relationships between SCEs (HRQoL) and mediators (self-compassion, body image inflexibility (BII)) among 302 Iranian women with breast cancer (2023–2024). This cross-sectional design employed structural equation modeling with the Body and Appearance Self-Conscious Emotions Scale (BASES), Functional Assessment of Cancer Therapy-Breast (FACT-B), Body Image Psychological Inflexibility Scale (BIPIS), and Self-Compassion Scale-Short Form (SC-SF). The data were analyzed via partial least squares with SPSS 27 and SmartPLS 4. Self-compassion mediated BASES’s effects on BII and HRQoL, but BII did not mediate BASES-HRQoL. Notably, self-compassion showed significant negative mediation effects. The findings highlight self-compassion’s complex role, unexpectedly inversely influencing (HRQoL) and BII. The study underscores the need for nuanced psychological interventions addressing self-compassion’s dual influence to optimize well-being in breast cancer care.