The relationship between self-efficacy and self-advocacy among young and middle-aged Chinese breast cancer patients: the mediating effect of health literacy.

BACKGROUND

Self-advocacy is a key indicator of effective patient participation in disease treatment and an effective way to promote patients' self-management skills, which plays an important role in improving patients' quality of life. However, we know little about the mechanisms of self-efficacy and self-advocacy in young and middle-aged breast cancer patients.

AIM: To explore the mediating role of health literacy between self-efficacy and self-advocacy in young and middle-aged breast cancer patients, and to provide a theoretical basis for the implementation of intervention strategies to enhance self-advocacy in breast cancer patients.

METHODS

This study utilized a cross-sectional research design and included 262 young and middle-aged breast cancer patients as study participants. These patients completed paper-based questionnaires covering demographic information, self-efficacy assessment, health literacy measures, and a self-advocacy survey. SPSS 26.0 software and AMOS 24.0 software were used to analyze the data, and structural equation modeling was constructed to provide insight into the relationships among the variables.

RESULTS

The results of the study showed that the self-advocacy score was 80.94 ± 8.56. Self-advocacy was positively correlated with self-efficacy (r = 0.305; p < 0.01) and health literacy (r = 0.484; p < 0.01), while self-efficacy was positively correlated with health literacy (r = 0.327; p < 0.01). In addition, health literacy partially mediated the effect between self-efficacy and self-advocacy (mediating effect of 0.254,95% CI: 0.147-0.398, accounting for 54.3% of the total effect).

CONCLUSIONS

Self-efficacy of young and middle-aged breast cancer patients has a significant direct impact on self-advocacy and further enhances self-advocacy through health literacy. Therefore, enhancing patients' self-efficacy and improving health literacy are effective ways to improve self-advocacy.