Abstract
Purpose The study explores the parallel mediating effect of social support and suitable medication self-efficacy between cancer-related fatigue (CRF) and oral chemotherapy adherence in glioma patients to improve efficacy.
Patients and methods 464 glioma patients were recruited through convenient sampling from a Three-A hospital in Urumqi, Xinjiang, and Three-A hospitals in Chengdu, Sichuan, between December 2023 and June 2024. The general information questionnaire and Brief Fatigue Inventory (BFI) were chosen to investigate the general information and degree of fatigue in such patients. The Social Support Rating Scale (SSRS), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), and 8-Item Morisky Medication Adherence Scale (MMAS-8) helped evaluate the social support degree, appropriate medication self-efficacy, and medication adherence.
Results The scores of SSRS, SEAMS, BFI, and MMAS-8 were 38.3±7.29, 27.83±6.66, 4.57±1.48, and 4.53±1.92, respectively. Pearson correlation analysis indicated that oral chemotherapy adherence is negatively associated with CRF (P<0.01) but positively correlates with appropriate medication self-efficacy and social support. Three statistical methods, causal stepwise analysis, Bootstrap, and Mplus, confirmed that SSRS and SEAMS exert complete mediating effects. This accounted for 59.09% and 50.84% of the total effects, respectively. The indirect SEAMS effect pathway is affected by the masking effect.
Conclusion:CRF can directly suppress the oral chemotherapy adherence of glioma patients, influenced by social support and suitable medication self-efficacy.