Health behaviors and symptom clusters mediate self-management efficacy and quality of life in lung cancer immunotherapy

To explore the association between self-management efficacy and quality of life in patients undergoing immunotherapy for lung cancer, and examine the mediating role of health promotion and symptom clusters in these two variables. This survey was conducted with 348 lung cancer survivors. Participants completed the Self-Management Efficacy Scale for Cancer Patients, the Health -Promoting Lifestyle Scale Ⅱ, the Functional Assessment of Cancer Therapy, the Chinese Version of Memorial Symptom Assessment Scale. The hypothesized model was tested using structural equation modeling. Both health promotion (β = 0.312, p < 0.001) and symptom clusters (β = 0.080, p < 0.001) partially mediated the association between self-management efficacy and quality of life. Additionally, health promotion and symptom clusters had a chain-mediating effect (β = 0.087, p < 0.001) on quality of life. Results suggest that patients with higher self-management efficacy demonstrate greater engagement in proactive health-promoting behaviors. These behaviors, in turn, appear to mitigate the negative impact of treatment-related symptom clusters, ultimately leading to improve quality of life.