Coping style and social support as modifiable mediators between personality and self-perceived speech handicap in head and neck cancer patients with tracheostomy: a cross-sectional chain-mediation study

Objective – This study sought to elucidate the chain mediation effects of coping style and social support linking extraversion-introversion personality to self-perceived speech handicap in head and neck cancer patients with tracheostomy. Methods – A cross-sectional survey was conducted among 217 post-tracheostomy patients (January 2023–June 2024). Data collection was conducted through questionnaire surveys employing a general information questionnaire, the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, the Social Support Rating Scale, the Simplified Coping Style Questionnaire, and the Chinese version of the Speech Handicap Index. The outcome was the total SHI score, a patient-reported measure of self-perceived speech handicap; communication ability was not directly measured. Results – The mean score for extraversion-introversion personality traits among participants with tracheostomy was 51.798 ± 11.240, for positive coping style was 30.790 ± 7.240, for social support was 40.862 ± 9.024, and for the Speech Handicap Index was 73.230 ± 24.227. Speech handicap exhibited significant negative correlations (p < 0.01) with extraversion-introversion personality traits (r = −0.445), coping style (r = −0.410), and social support (r = −0.402). Both positive coping style and social support significantly mediated the association between extraversion-introversion personality traits and self-perceived speech handicap in head and neck cancer patients with tracheostomy, with mediation effect values of −0.682 and −0.425, respectively. Furthermore, a chain mediation effect was observed along the “positive coping style → social support” pathway (−0.201), accounting for 6.26% of the total effect. Conclusion – Path analysis identifies an associative relationship between extraversion-introversion personality traits and self-perceived speech handicap that is potentially explained by the chained mediating roles of coping style and social support. As patients’ extraversion-introversion personality traits are difficult to modify, optimization of coping style and enhancement of social support levels in clinical practice may constitute primary intervention strategies for reducing self-perceived speech handicap in these patients.