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ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

The relationship between self-efficacy and self-advocacy among young and middle-aged Chinese breast cancer patients: the mediating effect of health literacy.

Xinyi Wang, Shan Zhang, Jing Wang, Xue Li, Yawen Zheng, Rong Wang, Baohua Cao, Qiang Li

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 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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8 authors.

Xinyi Wang *Department of Nursing, HanZhong Central Hospital, Hanzhong, Shaanxi, China.
Shan Zhang *Department of Nursing, The 950th Hospital of PLA, Yecheng, Xinjiang, China.
Jing Wang *Department of Nursing, HanZhong Central Hospital, Hanzhong, Shaanxi, China.
Xue LiSchool of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Yawen ZhengSchool of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Rong WangDepartment of Thoracic Surgery, HanZhong Central Hospital, Hanzhong, Shaanxi, China. 1758502212@qq.com.
Baohua CaoDepartment of Nursing, Air Force Medical University, Xi'an, Shaanxi, China. cbh528@fmmu.edu.cn.
Qiang LiDepartment of Thoracic Surgery, HanZhong Central Hospital, Hanzhong, Shaanxi, China. 119711910075@sjtu.edu.cn.

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6 · The paper itself

Abstract

backgroundSelf-advocacy is a key indicator of effective patient participation in disease treatment and an effective way to promote patients' self-management skills, which plays an important role in improving patients' quality of life. However, we know little about the mechanisms of self-efficacy and self-advocacy in young and middle-aged breast cancer patients.

aimTo explore the mediating role of health literacy between self-efficacy and self-advocacy in young and middle-aged breast cancer patients, and to provide a theoretical basis for the implementation of intervention strategies to enhance self-advocacy in breast cancer patients.

methodsThis study utilized a cross-sectional research design and included 262 young and middle-aged breast cancer patients as study participants. These patients completed paper-based questionnaires covering demographic information, self-efficacy assessment, health literacy measures, and a self-advocacy survey. SPSS 26.0 software and AMOS 24.0 software were used to analyze the data, and structural equation modeling was constructed to provide insight into the relationships among the variables.

resultsThe results of the study showed that the self-advocacy score was 80.94 ± 8.56. Self-advocacy was positively correlated with self-efficacy (r = 0.305; p < 0.01) and health literacy (r = 0.484; p < 0.01), while self-efficacy was positively correlated with health literacy (r = 0.327; p < 0.01). In addition, health literacy partially mediated the effect between self-efficacy and self-advocacy (mediating effect of 0.254,95% CI: 0.147-0.398, accounting for 54.3% of the total effect).

conclusionsSelf-efficacy of young and middle-aged breast cancer patients has a significant direct impact on self-advocacy and further enhances self-advocacy through health literacy. Therefore, enhancing patients' self-efficacy and improving health literacy are effective ways to improve self-advocacy.

Indexed as

Breast NeoplasmsHealth LiteracySelf EfficacySelf-ManagementAdultChinaCross-Sectional StudiesEast Asian PeopleFemaleHumansMiddle AgedQuality of LifeSurveys and QuestionnairesYoung AdultBreast cancerHealth literacySelf-advocacySelf-efficacy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.