Therapy-Related Symptoms and Sense of Coherence: The Mediating Role of Social Support and Hope in Lung Cancer Patients Undergoing Chemotherapy.

Aim: To investigate the current status of the sense of coherence in lung cancer patients undergoing chemotherapy and explore the mediating role of social support and hope in the relationship between therapy-related symptoms and sense of coherence. Methods: We conducted a cross-sectional study to investigate lung cancer chemotherapy patients aged 18 years or older who completed at least two cycles of chemotherapy. Patients were recruited from the First Affiliated Hospital of Guangzhou Medical University's chemotherapy day ward from May to December 2023. Patients were required to complete a questionnaire that included the Sense of Coherence Scale, the Perceived Social Support Scale, the Herth Hope Index, and the Therapy-related Symptoms Checklist. The structural equation model was used to test the mediating role of social support and hope between therapy-related symptoms and the sense of coherence. Results: A total of 241 patients were included. The scores of the sense of coherence, hope level, therapy-related symptoms, and social support were 68.79 ± 11.24, 38.94 ± 4.25, 11.53 ± 8.15, and 69.49 ± 8.15, respectively. Sense of coherence, social support, hope, and therapy-related symptoms were significantly related (P<0.01). Therapy-related symptoms had a direct negative influence on the sense of coherence [B=-0.144, 95% CI (-0.209, -0.070)]. Meanwhile, therapy-related symptoms influenced the sense of coherence via three pathways: independent mediation of social support [B=-0.021, 95% CI (-0.065, -0.002)], independent mediation of hope [B=-0.022, 95% CI (-0.057, -0.000)], and chain mediation of social support and hope [B=-0.012, 95% CI (-0.035, -0.002)]. Conclusion: Lung cancer patients undergoing chemotherapy experience a medium sense of coherence. This study's findings indicate that the relationship between therapy-related symptoms and sense of coherence is affected by the independent mediating effect of social support and hope and the chain mediating effect of social support and hope. Therefore, reducing the burden of their therapy-related symptoms, providing them with social support, and fostering their hope can enhance patients' sense of coherence and improve their quality of life.