Biological Stress Indicators based on Perceived Stress mediated by Emotional Regulation among Patients with Gastrointestinal Cancer: A Structural Equation Modeling

Background: Cancer is a disorder in the rate of cell proliferation and differentiation that can occur in any tissue of the body and at any age, and attacking healthy tissues of the body causes severe disease and consequently death. Objective: This study aimed to analyze biological indicators of stress based on perceived stress mediated by emotional regulation among patients with gastrointestinal cancer using structural equation modeling. Methods: This descriptive-correlational research was conducted based on a structural equation modeling approach. The statistical population of the present study included all patients with gastrointestinal cancer referred to Reza-Mashhad medical center and Avicenna Hospital, Tehran, Iran, and diagnosed with this disease based on the patient’s medical record. The sample of this study included 250 cases selected using non-random and available sampling methods. The required data in this study were obtained using the questionnaires, namely the Perceived Stress Scale, Cognitive Emotion Regulation Questionnaire, and Biological Indicators of Stress. The collected data were analyzed in SPSS software (version 22) and AMOS software (version 22) using structural equation modeling and Pearson correlation coefficient. Results: The results showed that perceived stress (β=-0.37, P 0.001) directly affected emotional regulation. Moreover, emotional regulation (β=0.54, P 0.001) had a direct effect on biological stress indices. Emotional regulation played a mediating role in the relationship between perceived stress and biological stress indices (root mean square error of approximation:0.001; adjusted goodness of fit: 0.93). Conclusion: It can be concluded that the biological indicators of stress in patients with gastrointestinal cancer based on perceived stress mediated by emotional regulation using structural equation modeling had a good fit.