Mediation Effects of Self-care Self-efficacy and Health-promoting Behaviors on Fear of Cancer Recurrence and Posttraumatic Growth in Postoperative Patients With Cervical Cancer: A Cross-sectional Study

Purpose: High recurrence risks significantly contribute to poor health outcomes among postoperative cervical cancer patients. This study aimed to determine the impact of fear of cancer recurrence (FCR) on the posttraumatic growth (PTG) in postoperative cervical cancer patients and to investigate the mediating effects of self-care self-efficacy and health-promoting behaviors within this relationship. Methods: A total of 334 cervical cancer patients who had undergone surgery in three tertiary hospitals in Liaoning Province, China, were recruited using a convenience sampling method. Data were collected using the general information questionnaire, the Fear of Progression Questionnaire (FCR), the Post-traumatic Growth Inventory (PTG), the Strategies Used by People to Promote Health (self-care self-efficacy), and the Health-Promoting Lifestyle Profile (health-promoting behaviors). Data analysis was performed using descriptive analysis, Pearson's correlations, and multiple linear regression analysis. A structural equation model was conducted using Amos 24.0 software. Results: PTG of cervical cancer patients after surgery was significantly and negatively associated with FCR (r = -.54, p < .001), while positively correlated with self-care self-efficacy (r = .51, p < .001) and health-promoting behaviors (r = .59, p < .001). The mediation model revealed that self-care self-efficacy (Boots 95% CI 0.39 similar to 0.15) and health-promoting behaviors (Boots 95% CI 0.51 similar to 0.24) independently served as mediating factors, respectively. Self-care self-efficacy and health-promoting behaviors played a significant chain mediating effect between FCR and PTG (Boots 95% CI 0.19 similar to 0.07), with an indirect effect of 11.6%. Conclusion: This study demonstrated that self-care self-efficacy and health-promoting behaviors partially mediated the relationship between FCR and PTG in cervical cancer survivors after surgery. Implementing tailored interventions that focus on enhancing self-care self-efficacy and health-promoting behaviors among cervical cancer survivors may help alleviate concerns about cervical cancer recurrence and enhance PTG following surgery. (c) 2024 Korean Society of Nursing Science. Published by Elsevier BV. This is an open access article underthe CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).