Effect of the disease uncertainty on health promotion behavior in malignant lymphoma patients treated with chemotherapy: the chain mediating role of mental resilience and health empowerment

Objective  To explore the chain mediating effects of mental resilience and health empowerment in the disease uncertainty and health promotion behavior in malignant lymphoma patients treated with chemotherapy, to provide the scientific theoretical guidance for the implementation of effective nursing intervention for patients.

Methods  A total of 210 malignant lymphoma patients treated with chemotherapy were selected as the study subjects.The patients were investigated using the general data questionnaire, disease uncertainty scale, health promotion lifestyle scale Ⅱ, resilience scale and health empowerment scale.The correlations among the mental resilience, health empowerment, disease uncertainty and health promotion behavior were analyzed by Pearson analysis.The structural equation model was established by Amos 21.0 software, and the mediating effects were tested.

Results  The mental resilience score, health empowerment score, disease uncertainty score and health promotion behavior score in malignant lymphoma patients treated with chemotherapy were (42.34±6.28) points, (27.62±3.44) points, (109.85±11.24) points and (118.34±12.76) points, respectively.The results of Pearson analysis showed that the health promotion behavior was negatively correlated with disease uncertainty(P < 0.05 to P < 0.01), and positively correlated with mental resilience and health empowerment(P < 0.05 to P < 0.01).The mediating effects of mental resilience and health empowerment on disease uncertainty and health promotion behavior were established.The total indirect effect was 35.37%, the specific mediating effect of mental resilience accounted for 17.57%, the specific mediating effect of health empowerment accounted for 13.38%, and the chain mediating effect of mental resilience and health empowerment accounted for 4.42%.

Conclusions  The chain mediation effect of mental resilience and health empowerment on the relationship between disease uncertainty and health promotion behavior is established, which confirms that the disease uncertainty can affect health promotion behavior by regulating the level of mental resilience and health empowerment.