ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Self-care agency and medication adherence among cancer patients receiving oral chemotherapy: a path analysis study.
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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Abstract
purposeOral chemotherapy shifts substantial treatment responsibility to patients and requires sustained engagement in medication use, symptom monitoring, follow-up, and communication with healthcare professionals. This study aimed to determine levels of self-care agency and medication adherence among adults receiving oral chemotherapy and to examine the relationship between adherence-related behaviors and self-care agency.
methodsThis descriptive cross-sectional study included 140 adult cancer patients receiving oral chemotherapy at oncology outpatient clinics in Türkiye. Data were collected using a Sociodemographic and Clinical Characteristics Form, the Self-Care Agency Scale (SCAS), and the Oral Chemotherapy Adherence Scale (OCAS). Descriptive statistics, group comparisons, Pearson correlation analysis, and a theory-specified observed-variable mediation path model were used, in which basic conditioning factors (age, gender, education, income, comorbidity, treatment duration, and side effect burden) predicted self-care agency, which in turn predicted the three oral chemotherapy adherence subdimensions; indirect (mediated) effects were tested with 5000 bias-corrected bootstrap resamples.
resultsThe mean SCAS total score was 56.78 ± 17.42, which was below the midpoint of the possible scale range (0-140), whereas oral chemotherapy adherence was suboptimal, with the OCAS mean (77.92 ± 10.71) below the developer-defined good-adherence threshold of 84; 78.6% of participants were classified as having suboptimal adherence and 21.4% reached the good-adherence threshold. Total SCAS and OCAS scores were moderately and positively correlated (r = 0.43, p < 0.001). In the mediation path model, the test of the 18 omitted direct paths rejected exact fit (χ
conclusionSelf-care agency and oral chemotherapy adherence were positively related, and income, education, age, and gender showed significant indirect associations with adherence through self-care agency, indicating that socioeconomic and demographic differences in adherence-related behaviors operate partly through self-care capacity; as cross-sectional associations, these findings do not establish causal mediation. Oncology nursing interventions should therefore combine adherence-support strategies with equity-sensitive education and follow-up approaches, particularly for patients with lower education and income levels.
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