The role of emotion regulation, self-compassion, and perceived lifestyle discrepancy in maintaining a healthy lifestyle among breast cancer survivors

Aims: An unhealthy lifestyle elevates the risk of comorbidities, cancer recurrence, and diminished quality of life among breast cancer survivors. Yet, the influence of psychosocial factors on sustaining healthy lifestyle behaviors (physical activity and healthy diet) in this population remains underexplored. The present study investigated healthy lifestyle practices and the associations of perceived lifestyle discrepancy, self-compassion, and emotional distress with lifestyle maintenance among breast cancer survivors, as well as the mediating role of emotion regulation strategies (cognitive reappraisal and expressive suppression) in these associations.

Method: A total of 145 female breast cancer survivors, aged 31 to 77, completed self-report questionnaires assessing healthy lifestyle maintenance, perceived lifestyle discrepancies, self- compassion, and emotion regulation patterns. Data were analyzed using structural equation modeling.

Results: Mean scores for physical activity and healthy diet maintenance were at a moderate level. Only 30% of the survivors met the recommended guidelines for physical activity, and nearly 41% reported primarily sedentary work. Dietary patterns for most nutritional components were below the recommendations of the World Cancer Research Fund/American Institute for Cancer Research. For instance, just over half of the participants adhered to the daily recommended servings of fruits, vegetables, or whole grains. The average Body Mass Index (BMI) was 25.92 (SD = 4.74), slightly exceeding the recommended range.

Structural equation modeling indicated good model fit. Lower perceived lifestyle discrepancy was directly associated with greater engagement in physical activity and healthier dietary patterns. Self-compassion was positively associated with physical activity but not with diet. Cognitive reappraisal was linked to higher expressive suppression and lower physical activity, and both constructs mediated the association between self-compassion and physical activity.

Discussion: The findings underscore the significance of psychosocial factors—specifically self-compassion, perceived lifestyle discrepancy, and emotion regulation patterns—in supporting the maintenance of a healthy lifestyle among breast cancer survivors. Providing lifestyle recommendations alone may not be sufficient to ensure adherence. We suggest that health professionals assess and address survivors’ perceived discrepancies and their emotional and behavioral implications. Moreover, fostering adaptive emotion regulation patterns and cultivating self-compassion may promote both well-being and long-term healthy lifestyle maintenance.