Self-Efficacy and e-Health Literacy Among Caregivers of Patients With Lung Cancer: The Chain-Mediating Roles of Negative Emotions and Caregiver Readiness.

Objectives: To explore the chain-mediating roles of negative emotions and caregiver readiness between self-efficacy and e-health literacy among caregivers of patients with lung cancer.

Background: With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.

Design: A cross-sectional survey.

Methods: A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples t-tests and a one-way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.

Reporting method: The STROBE checklist was used for this study.

Results: The total e-health literacy score of caregivers of patients with lung cancer was 29.65 ± 7.11, and there was a correlation between self-efficacy, negative emotions, caregiver readiness, and e-health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain-mediating roles between self-efficacy and e-health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.

Conclusions: Caregivers of patients with lung cancer exhibit moderate levels of e-health literacy. This research suggests that self-efficacy not only has a direct and positive influence on e-health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.

Relevance to clinical practice: Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.

Patient or public contribution: Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.