Effect of breathlessness beliefs on quality of life in chronic obstructive pulmonary disease: Chain-mediating role of self-efficacy and self-management behaviors

This study aimed to investigate the impact of beliefs about breathlessness on health-related quality of life (HRQoL) among chronic obstructive pulmonary disease (COPD) patients and to explore whether self-efficacy and self-management behaviors mediate this relationship. A cross-sectional study was conducted with 287 Chinese COPD patients. Mediation analysis was performed using structural equation modeling with Amos 24.0. The findings indicated that self-efficacy and self-management behaviors independently mediated the relationship between breathlessness beliefs and HRQoL, accounting for 28.91% and 33.01% of the overall effect, respectively. Additionally, a serial mediating effect of self-efficacy and self-management behaviors was found in the link between breathlessness beliefs and HRQoL, accounting for 6.33% of the total effect. This finding demonstrated that self-efficacy and self-management behaviors served as sequential mediators in the relationship between breathlessness beliefs and HRQoL. Targeted interventions should be developed to address breathlessness beliefs, enhance self-efficacy, and promote self-management behaviors, ultimately improving HRQoL.