Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Determinants of self-management among gastrointestinal cancer patients undergoing chemotherapy: a structural equation modeling analysis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Cao Yuling, Zheng Suna, Zhang Xiaoju, Yang Yang, Peng Jian, Jia Lingying, Hu Yan
Аннотация
PURPOSE: Gastrointestinal cancers represent a significant global health burden, particularly in East Asia where incidence and mortality rates remain high. Although chemotherapy is a primary treatment strategy, its adverse effects often undermine treatment adherence and patient well-being. This study aimed to examine the psychosocial determinants of self-management behaviors in gastrointestinal cancer patients undergoing chemotherapy by applying a structural equation modeling (SEM) approach.
METHODS: A cross-sectional study was conducted among 753 gastrointestinal cancer patients receiving chemotherapy at eight tertiary hospitals in China. Participants completed validated instruments assessing self-management behaviors, self-efficacy, medical coping strategies, perceived social support, and psychological distress. Structural equation modeling was used to investigate the direct, indirect, and mediating effects among the variables.
RESULTS: The SEM analysis revealed that self-efficacy had both a direct and indirect positive effect on self-management behaviors, mediated by adaptive coping strategies. Perceived social support was significantly associated with increased self-efficacy and adaptive coping, while psychological distress negatively influenced self-management, primarily through reduced self-efficacy and increased maladaptive coping. The final model demonstrated good fit indices (CFI = 0.950, TLI = 0.933, RMSEA = 0.065), supporting the hypothesized relationships.
CONCLUSIONS: Self-management in gastrointestinal cancer patients undergoing chemotherapy is influenced by a complex interplay of psychosocial factors. Interventions that target self-efficacy enhancement, encourage adaptive coping, and strengthen social support systems may be critical to improving treatment adherence and patient outcomes.
METHODS: A cross-sectional study was conducted among 753 gastrointestinal cancer patients receiving chemotherapy at eight tertiary hospitals in China. Participants completed validated instruments assessing self-management behaviors, self-efficacy, medical coping strategies, perceived social support, and psychological distress. Structural equation modeling was used to investigate the direct, indirect, and mediating effects among the variables.
RESULTS: The SEM analysis revealed that self-efficacy had both a direct and indirect positive effect on self-management behaviors, mediated by adaptive coping strategies. Perceived social support was significantly associated with increased self-efficacy and adaptive coping, while psychological distress negatively influenced self-management, primarily through reduced self-efficacy and increased maladaptive coping. The final model demonstrated good fit indices (CFI = 0.950, TLI = 0.933, RMSEA = 0.065), supporting the hypothesized relationships.
CONCLUSIONS: Self-management in gastrointestinal cancer patients undergoing chemotherapy is influenced by a complex interplay of psychosocial factors. Interventions that target self-efficacy enhancement, encourage adaptive coping, and strengthen social support systems may be critical to improving treatment adherence and patient outcomes.