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European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2026

Emotional support receipt and health-related quality of life in cancer: Serial mediation through a cognitive-affective pathway.

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García-Alonso Elena, Ubillos-Landa Silvia, Crespo Herrero Guillermo

Аннотация

BACKGROUND: Emotional support (ES) is a key psychosocial determinant of cancer adjustment. Emotional Support Receipt (ESR) is a nurse-assessable interpersonal resource linked to Health-Related Quality of Life (HRQoL) through a cognitive-affective processes.

OBJECTIVE: To examine whether ESR relates to higher HRQoL through proactive coping strategies and lower emotional distress in adults undergoing cancer treatment.

METHODS: Cross-sectional study at a tertiary hospital in Spain. Adults with cancer (n = 360) completed validated Spanish versions of Brief-COPE (ESR, active coping, informational support, planning, positive reframing, acceptance, humour), HADS (distress), and EORTC QLQ-C30 (global HRQoL), plus sociodemographic/clinical data. Analyses included descriptive statistics, correlations, hierarchical linear regression (Block 1: clinical covariates; Block 2: proactive coping skills; Block 3: distress), and serial mediation (PROCESS Model 6; 10,000 bias-corrected bootstraps; 95% CI).

RESULTS: Positive reframing independently predicted higher HRQoL (Block 2); distress was the strongest negative predictor (Block 3). These variables were included as serial mediators. The total effect of ESR on HRQoL was significant (c = 4.087, p = 0.002), whereas the direct effect was not after including the mediators (c' = 1.713; p = 0.171). The serial processes ESR → positive reframing → emotional distress → HRQoL was significant (B = 1.665; 95% CI [0.980, 2.518]). The model explained 28.3% of HRQoL variance.

CONCLUSIONS: ESR related to better HRQoL via a serial cognitive-affective mechanism. Findings highlight scalable targets for nurse-led stepped care: routine screening of ESR and distress, brief training in cognitive reframing, and reinforcement of support networks, with HRQoL monitored as an outcome.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты