Dual-Pathway Mechanisms of Cancer Screening Decisions Among Family Caregivers in China: A Mixed-Methods Study

This study used an exploratory sequential mixed-methods design to investigate the dual-pathway mechanisms influencing cancer screening decisions among family caregivers of cancer patients. A dual-pathway model was developed through qualitative interviews (N = 20) and subsequently validated with quantitative surveys (N = 705). Key findings revealed two distinct pathways. The cognitive pathway showed that caregiving experience promoted screening intentions by enhancing information literacy self-efficacy via health information acquisition. In contrast, the affective pathway indicated that fear of cancer progression predicted greater emotional exhaustion, which in turn suppressed screening decisions. Furthermore, interaction between the two pathways was identified: information literacy self-efficacy buffered the negative impact of emotional exhaustion on screening decisions (β = -.18, p < .01), while emotional exhaustion attenuated the positive effect of information literacy self-efficacy (β = -.15, p < .05). These results reveal the interplay between cognitive and affective units, providing a theoretical foundation for designing dual-pathway ("cognitive empowerment-affective regulation") intervention.