ArticleAsia-Pacific journal of oncology nursing2026
Self-efficacy as a mediator between digital health literacy and self-care behaviors in older adults with cancer undergoing chemotherapy.
Article in Asia-Pacific journal of oncology nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To examine the association between digital health literacy and self-care behaviors and to test whether self-efficacy statistically mediates this association, after adjusting for relevant covariates, among older adults with cancer undergoing chemotherapy. Methods: A descriptive cross-sectional study was conducted with 117 older adults with cancer undergoing chemotherapy at a tertiary hospital in the Republic of Korea. Participants completed validated measures of digital health literacy (eHEALS), self-efficacy (CSSES-K), and self-care behaviors. Data were analyzed using regression-based mediation analysis (Hayes' PROCESS macro Model 4) with 5000 bootstrap samples, adjusting for sex, age, educational level, cancer diagnosis, and Eastern Cooperative Oncology Group (ECOG) performance status. Results: Digital health literacy was positively associated with self-efficacy ( Conclusions: The findings were compatible with an indirect-only mediation pattern, suggesting that digital health literacy may be linked to self-care behaviors primarily through self-efficacy among older adults undergoing chemotherapy. Interventions to promote self-care during chemotherapy may benefit from combining digital health literacy support with strategies that strengthen self-efficacy.
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