Observational studyBMJ open2025
Mediating roles of social connection and stress-coping self-efficacy in the association between physical activity and emotional distress among lung cancer survivors: a cross-sectional study.
Observational study in BMJ open, 2025. 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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9 authors.
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Abstract
objectivesAlthough previous studies have examined the psychological benefits of physical activity in cancer survivors, the underlying psychological mechanisms among lung cancer survivors remain poorly understood. This study aims to examine the parallel mediating roles of social connection and self-efficacy in stress coping in the association between physical activity and psychological distress (anxiety and depression) among Chinese lung cancer survivors.
designA cross-sectional observational study.
settingA tertiary care hospital in Shanghai, China.
participantsA total of 588 lung cancer survivors were recruited and assessed physical activity, anxiety, depression, social connection and self-efficacy in stress coping. Path analysis was conducted to examine the parallel mediating effects of social connection and self-efficacy in stress coping in the association between physical activity and psychological distress (anxiety and depression). OUTCOME MEASURES: The primary outcome was the examination of the mediating effects of social connection and self-efficacy in stress coping on the relationship between physical activity and psychological distress, assessed using path analysis.
resultsSocial connection (p=0.003 for anxiety; p<0.001 for depression) and self-efficacy in stress coping (p<0.001 for anxiety; p<0.001 for depression) significantly mediated the association between physical activity and psychological distress. Physical activity was positively associated with social connection and self-efficacy in stress coping, both of which were negatively associated with anxiety and depression. After controlling for the mediators, the direct effects of physical activity on anxiety and depression were no longer significant.
conclusionThese findings suggest that social connection and self-efficacy in stress coping may serve as critical psychological mechanisms underlying the association between physical activity and emotional well-being among Chinese lung cancer survivors. Interventions targeting anxiety and depression in lung cancer survivors may benefit from integrating strategies to enhance physical activity while promoting social connection and self-efficacy in coping to optimise psychological outcomes.
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