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. 2025 Jun 30:12:100749.
doi: 10.1016/j.apjon.2025.100749. eCollection 2025 Dec.

Social support and demoralization among patients with lung cancer in China: A moderated mediation model of self-efficacy and symptom distress

Zhiheng Ping  1   2 , Chunyan He  2 , Shuhui Liu  2 , Rong Tan  1 , Deying Hu  1   3
Affiliations

Social support and demoralization among patients with lung cancer in China: A moderated mediation model of self-efficacy and symptom distress

Zhiheng Ping et al. Asia Pac J Oncol Nurs. .

Abstract

Objective: To investigate whether the relationship between social support and demoralization in Chinese patients with lung cancer is mediated.

Methods: Between January and June of 2024, a comprehensive cross-sectional investigation was carried out at three top-tier hospitals in Hubei Province, China. A grand total of 418 individuals diagnosed with lung cancer participated in the research by filling out confidential self-assessment questionnaires. To gauge the mediating and moderating influences, the bootstrapping technique was applied for regression analysis.

Results: Among 418 patients with cancer, demoralization was negatively correlated with both social support (ρ ​= ​0.638, P ​< ​0.01) and self-efficacy (ρ ​= ​-0.749, P ​< ​0.01). Social support significantly predicted self-efficacy (B ​= ​0.334, P ​< ​0.01), which in turn was strongly associated with reduced demoralization (B ​= ​-1.130, P ​< ​0.001). Additionally, symptom distress moderated the effect of social support on self-efficacy (B ​= ​-0.003, P ​< ​0.05), with higher distress weakening the positive impact of social support on self-efficacy.

Conclusions: Social support plays a crucial role in enhancing self-efficacy, which subsequently contributes to the reduction of demoralization. However, it is important to note that symptom distress significantly undermines these beneficial effects, leading to heightened feelings of helplessness and hopelessness.

Keywords: Demoralization; Lung cancer; Self-efficacy; Social support; Symptom distress.

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Conflict of interest statement

The authors affirm that there are no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
The hypothesized moderated mediation model.
Fig. 2
Fig. 2
Simple slope analysis. M, mean; SD, standard deviation.
Fig. 3
Fig. 3
The final moderated mediation model. ∗∗∗P ​< ​0.001.
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