Illness perceptions and symptom burden in chemotherapy-induced peripheral neuropathy: a moderated mediation analysis...

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and often persistent adverse effect that contributes to substantial symptom burden and psychological distress among cancer survivors. However, the self-regulatory mechanisms linking patients' illness perceptions to these outcomes remain poorly understood. Guided by the Common-Sense Model of self-regulation, this study examined whether positive coping mediates the associations between illness perceptions and CIPN-related symptom burden and psychological distress, and whether mindfulness moderates these pathways.

A two-center cross-sectional survey enrolled 563 adults receiving platinum-based chemotherapy who reported CIPN symptoms. Validated questionnaires assessed CIPN symptom severity, psychological distress, illness perceptions, positive coping, mindfulness, and physical activity. Structural equation modeling with bootstrapping tested mediation and moderated mediation, adjusting for covariates.

More threatening illness perceptions were significantly associated with greater CIPN symptom burden and higher psychological distress. Positive coping partially mediated these associations, accounting for 51% of the total association with symptom burden and 37% with psychological distress. Mindfulness moderated key pathways, indicating that the strength of associations between illness perceptions, coping, and outcomes varied according to mindfulness levels.

These findings support a self-regulatory framework in which illness perceptions influence CIPN-related physical and psychological outcomes partly through coping processes, while mindfulness shapes vulnerability across pathways.

Interventions targeting illness perceptions, coping skills, and mindfulness may help cancer survivors better manage CIPN symptoms and psychological distress, thereby supporting more comprehensive survivorship care.