The mediating role of illness perception between Type D personality and psychological distress in preoperative patients with gynecologic cancers: A cross-sectional study

Objective To investigate the prevalence and influencing factors of psychological distress in preoperative gynecologic cancer patients, and to examine the mediating role of illness perception between Type D personality and psychological distress. Methods A cross-sectional study was conducted among 218 newly diagnosed gynecologic cancer patients from a provincial tertiary hospital in Hefei, China. Self-reported questionnaires were used to assess demographic and clinical characteristics, Type D personality, illness perception, and psychological distress. Mediation analysis was performed using bootstrapping (5,000 resamples) to estimate unstandardized path coefficients ( B ) with 95% confidence intervals (CI). Results The prevalence of preoperative psychological distress was 39.9%, which was associated with marital status, primary tumor site, Type D personality, and illness perception. Our results indicated the positive correlations of psychological distress with Type D personality ( r = 0.643, P < 0.001) and illness perception ( r = 0.723, P < 0.001). Mediation analysis suggested that the total effect of Type D personality on psychological distress was 0.195, while illness perception partially mediated the relationship ( B = 0.089, 95% CI: 0.062-0.118), accounting for 45.6% of the total effect. Conclusions Preoperative psychological distress was prevalent among gynecologic cancer patients. Both Type D personality and illness perception were significantly associated with psychological distress. The study indicated that Type D personality is associated with preoperative psychological distress, and this association may be partially explained by illness perception. Routine screening for Type D personality and targeted cognitive interventions addressing illness perception during the perioperative period may help reduce psychological distress in gynecologic cancer patients.