Correlation of health literacy, self-efficacy and social support with quality of life in patients with lung cancer in Chongqing: a study based on structural equation model

To investigate the current status of health literacy, self-efficacy, social support and quality of life in patients with lung cancer, and to explore the relationship among the 4 factors.

A total of 376 lung cancer patients were collected with convenience sampling and surveyed with questionnaires for general information, health literacy, social support, self-efficacy and quality of life. Amos was used to establish a structural equation model to analyze the relationship in the factors.

The total score of health literacy, social support and self-efficacy of these lung cancer patients was 96.34±19.57, 41.06±9.28 and 85.55±19.36, respectively. The score of general function, general health status and general symptoms in quality of life was 77.08±18.27, 46.13±18.17 and 24.02±17.75, respectively. Except social support and general health status, health literacy, social support and self-efficacy were correlated with all dimensions of quality of life（P<0.01）. The structural equation model showed that self-efficacy had only a direct effect on quality of life（an effect value of 0.382, P<0.01）. Health literacy directly affected quality of life or indirectly did through social support and self-efficacy（an effect value of 0.347, an indirect effect of 0.135, P<0.01）, with the largest effect. The model had a good fitting effect（GFI=0.940, AGFI=0.908, NFI=0.959, RFI=0.45, CFI=0.974, IFI=0.974, RMSEA=0.067）.

Health literacy and self-efficacy exert direct effects on the quality of life of lung cancer patients, and health literacy also indirectly affects the quality of life through social support and self-efficacy.