Other Titles

Investigation of the Mediating Role of Cancer Coping Self-Efficacy and Symptom Distress in Cancer Patients​ [Poster Title]

Abstract

Cancer symptoms significantly impact the quality of life (QOL) among cancer patients (Almståhl et al., 2019; Bashir et al., 2020; Nayak et al., 2019). Self-efficacy plays a key role in managing symptoms and improving QOL (Cox-Martin et al., 2020; Erickson et al., 2021; Frensham et al., 2020; Thieser et al., 2021; Wu et al., 2019). Symptom distress, defined as the suffering from symptom occurrence, predicts QOL in cancer patients with symptoms (Badana et al., 2019). However, it is not clear whether self-efficacy and/or symptom distress mediate the effects of symptoms on QOL. This study seeks to explore if and how self-efficacy and symptom distress mediate the relationship between symptom occurrence and QOL among cancer patients. This is a secondary data analysis of a randomized controlled trial including 534 cancer patients with moderate to high symptoms on active cancer treatment. We used a structural regression modeling approach.

The results from the final structural equation model revealed two mediating routes: cancer coping self-efficacy (week 4) (β = -0.035, B = -0.161, p = 0.000, CI95 = [-0.050, -0.021]) mediated the relationship between symptom occurrence (week 1) and QOL (week 10); cancer coping self-efficacy (week 4) and symptom distress (week 4) also work as serial mediators (β = -0.003, B = -0.013, p = 0.041, CI95 = [-0.006, -0.000]) between symptom occurrence (week 1) and QOL (week 10).

The findings provide evidence on the mechanism of how cancer-coping self-efficacy and symptom distress mediate the relationship between symptom occurrence and QOL among cancer patients. This study is only the beginning to investigate the causal mechanism of change, and a series of investigations are needed to verify such a mediating pathway to explain the change.

Notes

References:

Almståhl, A., Skoogh Andersson, J., Alstad, T., Fagerberg-Mohlin, B., & Finizia, C. (2019). Explorative study on quality of life in relation to salivary secretion rate in head and neck cancer patients treated with radiotherapy up to 2 years post treatment. International Journal of Dental Hygiene, 17(1), 46-54. https://doi.org/10.1111/idh.12363

Badana, A. N. S., Marino, V. R., Templeman, M. E., McMillan, S. C., Tofthagen, C. S., Small, B. J., & Haley, W. E. (2019). Understanding the roles of patient symptoms and subjective appraisals in well-being among breast cancer patients. Supportive Care in Cancer, 27(11), 4245-4252. https://doi.org/10.1007/s00520-019-04707-2

Bashir, A., Kumar, D., Dewan, D., & Sharma, R. (2020). Quality of life of head and neck cancer patients before and after cancer-directed treatment - A longitudinal study. Journal of Cancer Research and Therapeutics, 16(3), 500-507. https://doi.org/10.4103/jcrt.JCRT_311_18

Cox-Martin, E., Cox, M. G., Basen-Engquist, K., Bradley, C., & Blalock, J. A. (2020). Changing multiple health behaviors in cancer survivors: smoking and exercise. Psychology, Health & Medicine, 25(3), 331-343. https://doi.org/10.1080/13548506.2019.1679849

Erickson, J. M., Tokarek, N., Ke, W., & Swartz, A. (2021). A randomized controlled trial of a physical activity intervention for self-management of fatigue in adolescents and young adults with cancer. Cancer Nursing, 44(4), 263-271. https://doi.org/10.1097/ncc.0000000000000834

Frensham, L. J., Parfitt, G., & Dollman, J. (2020). Predicting Engagement With Online Walking Promotion Among Metropolitan and Rural Cancer Survivors. Cancer Nursing, 43(1), 52-59. https://doi.org/10.1097/ncc.0000000000000649

Nayak, S. G., Pai, M. S., & George, L. S. (2019). Quality of life of patients with head and neck cancer: A mixed method study. Journal of Cancer Research and Therapeutics, 15(3), 638-644. https://doi.org/10.4103/jcrt.JCRT_1123_16

Thieser, S., Dörfler, J., Rudolph, I., Wozniak, T., Schmidt, T., & Hübner, J. (2021). Influence of ballroom dancing on fatigue, body image, self-efficacy, and endurance of cancer patients and their partners. Medical Oncology, 38(2), 15. https://doi.org/10.1007/s12032-021-01459-0

Wu, W. W., Yu, T. H., Jou, S. T., & Hung, G. Y. (2019). Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. European Journal of Cancer Care, 28(4), e13045. https://doi.org/10.1111/ecc.13045

Description

Using a structural equation modeling approach, we tested the mediating effects of self-efficacy and symptom distress while accounting for measurement errors to provide more accurate parameters. Our results confirmed the their mediator roles. The findings from our study showed the importance of incorporating self-efficacy into interventions; and individuals with high symptom distress could be less responsive to self-efficacy interventions, which should be addressed early in interventions.

Author Details

Kailei Yan, PhD; Hsiao-Lan Wang, PhD; Brent Small, PhD; Victoria Marshall, PhD; Amanda Elliott, PhD; Danielle Tometich, PhD; Theresa Beckie, PhD; Susan C. McMillan, PhD

Note: The order and number of authors did not agree when entries in the Sigma event system were compared with the names listed on the poster. Author names may not be in the correct order due to this discrepancy.

Sigma Membership

Delta Beta at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Primary Care, Theory, Implementation Science, Promoting Clinical Outcomes, Self-Efficacy, Stress and Coping, Cancer Patients

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-27

Click on the above link to access the poster.

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The Mediating Role of Self-Efficacy and Symptom Distress in Cancer Patients

Indianapolis, Indiana, USA

Cancer symptoms significantly impact the quality of life (QOL) among cancer patients (Almståhl et al., 2019; Bashir et al., 2020; Nayak et al., 2019). Self-efficacy plays a key role in managing symptoms and improving QOL (Cox-Martin et al., 2020; Erickson et al., 2021; Frensham et al., 2020; Thieser et al., 2021; Wu et al., 2019). Symptom distress, defined as the suffering from symptom occurrence, predicts QOL in cancer patients with symptoms (Badana et al., 2019). However, it is not clear whether self-efficacy and/or symptom distress mediate the effects of symptoms on QOL. This study seeks to explore if and how self-efficacy and symptom distress mediate the relationship between symptom occurrence and QOL among cancer patients. This is a secondary data analysis of a randomized controlled trial including 534 cancer patients with moderate to high symptoms on active cancer treatment. We used a structural regression modeling approach.

The results from the final structural equation model revealed two mediating routes: cancer coping self-efficacy (week 4) (β = -0.035, B = -0.161, p = 0.000, CI95 = [-0.050, -0.021]) mediated the relationship between symptom occurrence (week 1) and QOL (week 10); cancer coping self-efficacy (week 4) and symptom distress (week 4) also work as serial mediators (β = -0.003, B = -0.013, p = 0.041, CI95 = [-0.006, -0.000]) between symptom occurrence (week 1) and QOL (week 10).

The findings provide evidence on the mechanism of how cancer-coping self-efficacy and symptom distress mediate the relationship between symptom occurrence and QOL among cancer patients. This study is only the beginning to investigate the causal mechanism of change, and a series of investigations are needed to verify such a mediating pathway to explain the change.