The Mediating Role of Mammography Self-Efficacy in the Effect of Cancer Attitudes on Fear of Breast Cancer in Women

Objectives: To determine the relationship between the attitudes toward cancer and the fear of breast cancer of women aged 40 to 69 and to examine the mediating role of mammography self-efficacy in this relationship. Methods: This descriptive and cross-sectional study was conducted involving 551 women between May and October 2023. Data were collected using the “Champion Breast Cancer Fear Scale,” “Cancer Measuring Attitudes Survey,” and “Mammography Self-Efficacy Scale.” Statistical analysis was performed using the Statistical Package for Social Sciences version 26.0, Process Macro program, and AMOS 24 package program. Results: The effect of attitude toward cancer on mammography self-efficacy, which is a mediating variable, was found to be negative and significant (P <.001). It was determined that the effect of mammography self-efficacy on the outcome variable, fear of breast cancer, was positive and significant. Furthermore, the direct effect of attitude toward cancer on the outcome variable, fear of breast cancer, was positive and significant (P <.05). Additionally, mammography self-efficacy was found to mediate the relationship between cancer-related attitudes and fear of breast cancer. Conclusions: This study has indicated that as women's negative attitudes toward cancer increase, their mammography self-efficacy levels decrease; that as breast cancer fears increase, mammography self-efficacy levels increase, and that as negative attitudes toward cancer increase, breast cancer fears increase. Additionally, the mediating role of the mammography self-efficacy variable in the relationship between attitude toward cancer and fear of breast cancer was found to have a low-magnitude effect. Implications for Nursing Practice: These results provide a valuable framework for developing educational interventions aimed at improving early diagnosis behaviors and emphasizing the importance of activating programs aimed at increasing self-efficacy and reducing barriers to access to mammography, especially in women with low socio-economic levels.