Trajectories of Psychological Detachment and Associated Factors Among Family Caregivers of Patients with Breast Cancer Receiving Postoperative Chemotherapy.

OBJECTIVE: The aim of this study was to identify latent trajectory classes of psychological detachment and examine factors associated with class membership among family caregivers of patients with breast cancer (BC) undergoing postoperative chemotherapy. METHODS: A convenience sample of 220 family caregivers of patients with BC undergoing postoperative chemotherapy was recruited from the breast surgery departments of two tertiary Grade A hospitals in Suzhou Municipal Hospital between December 2023 and December 2024. Baseline data were collected from caregivers prior to the first chemotherapy cycle (T0). Follow-up assessments were conducted using the Psychological Detachment Scale (PD) at three time points: after the first chemotherapy cycle (T1), at the midpoint of chemotherapy (T2), and after completion of chemotherapy (T3). Growth Mixture Modeling was applied to identify latent trajectory classes of psychological detachment. Multinomial logistic regression analysis was performed to assess factors associated with trajectory class membership. RESULTS: A total of 200 caregivers completed the full follow-up assessment. At T0, T1, T2, and T3, the mean PD scores among caregivers were 6.74 ± 1.30, 5.75 ± 0.96, 9.14 ± 1.49, and 11.85 ± 1.66, respectively. Three distinct trajectory classes were identified: a high-level detachment group (69.0%), a moderate-level detachment group (25.5%), and a low-level slow-increase detachment group (5.5%). Patient age, tumor stage, molecular subtype, caregiver burden, social support, and fear of cancer recurrence were significantly associated with psychological detachment trajectory class membership (p < 0.05). CONCLUSION: Psychological detachment trajectories differed among family caregivers of patients with BC undergoing postoperative chemotherapy, indicating population heterogeneity. Targeted interventions tailored to trajectory class characteristics and associated factors may support improvements in psychological detachment among caregivers. Given the small size of the low-level group, further validation in larger samples is warranted.