Abstract
BackgroundsSelf-efficacy plays an important role in pulmonary rehabilitation, but it is still unknown which factors exert their effects on postsurgical rehabilitation self-efficacy among non-small cell lung cancer (NSCLC) patients. This study aims to assess relationships among physical function, social factors, psychological factors, quality of life (QOL) and self-efficacy, and the effects of these variables on self-efficacy among NSCLC patients.MethodsA cross-sectional survey was administered to 238 postsurgical NSCLC patients (response rate 95.2%) at five tertiary hospitals in Fuzhou, China. the participants completed a pack of questionnaires. Structural equation modeling (SEM) was conducted to test the hypothetical model.ResultsThe SEM results supported the hypothesized structural model (χ2/df = 1.511, p>0.05). The final model showed that confrontation coping, subjective well-being (SWB), social support, psychological growth (PTG) and anxiety and depression can be directly related to self-efficacy (coefficient = 0.335, coefficient = 0.288, coefficient = 0.150, coefficient = 0.024, and coefficient = -0.004, respectively, p<0.01). Confrontation coping also had indirect effect via SWB (coefficient = 0.085, p<0.01), which had indirect connection via PTG (coefficient = 0.005, p<0.01). Social support and anxiety and depression had indirect pathways as well. As expected, self-efficacy directly affected the quality of life.ConclusionsThis study suggests that higher confrontation coping style, SWB, social support, and PTG and lower anxiety and depression levels could effectively enhance their self-efficacy and consequently, improve QOL. These findings may help develop an intervention aimed at enhancing self-efficacy for this patient population.
Highlights
Lung cancer is a leading cause of cancer mortality and morbidity worldwide [1]
Self-efficacy plays an important role in pulmonary rehabilitation, but it is still unknown which factors exert their effects on postsurgical rehabilitation self-efficacy among non-small cell lung cancer (NSCLC) patients
The final model showed that confrontation coping, subjective well-being (SWB), social support, psychological growth (PTG) and anxiety and depression can be directly related to self-efficacy
Summary
Lung cancer is a leading cause of cancer mortality and morbidity worldwide [1]. In China, the incidence of lung cancer has markedly increased over the last few decades and is predicted to be 1 million per year by 2025 [2,3]. Previous studies have investigated the relationship between self-efficacy and numerous cancer-related factors, including socio-demographic and clinical characteristics, physical function, psychological distress (e.g., anxiety and depression), psychological growth (i.e. post-traumatic growth, PTG), health behaviors and QOL [4,14,15,16]. The pathway or mechanism associating self-efficacy with physical or psychological health outcomes on cancer patients is not well understood. These previous studies have demonstrated such relationships through the use of self-efficacy as a mediator or independent variable, not as a dependent variable. A structural equation modeling (SEM), which analyzes both direct interrelationships of independent variables and their indirect effects through other variables [17], may help clarify the role of self-efficacy in lung cancer patients
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