Key result
Physical activity was positively associated with social connection and stress-coping self-efficacy, which significantly mediated its negative association with anxiety and depression (P<0.001).
Why the study?
The underlying psychological mechanisms linking physical activity to reduced emotional distress among lung cancer survivors remain poorly understood.
Does physical activity improve psychological distress through social connection and stress-coping self-efficacy in lung cancer survivors?
Cross-Sectional (n=588)
No
Does physical activity improve psychological distress through social connection and stress-coping self-efficacy in lung cancer survivors?
p-value: p=<0.001
Social connection and stress-coping self-efficacy mediate the psychological benefits of physical activity in lung cancer survivors.
May inform activity interventions targeting social connection and self-efficacy in lung cancer survivors; hypothesis-generating and needs prospective validation.
OBJECTIVES: Although 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. DESIGN: A cross-sectional observational study. SETTING: A tertiary care hospital in Shanghai, China. PARTICIPANTS: A 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. RESULTS: Social 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. CONCLUSION: These 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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Yang et al. (2025) conducted a cross-sectional in lung cancer survivors (n=588). Physical activity was evaluated on Mediating effects of social connection and self-efficacy in stress coping on the relationship between physical activity and psychological distress (p=<0.001). Physical activity was positively associated with social connection and stress-coping self-efficacy, which significantly mediated its negative association with anxiety and depression (P<0.001).
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