The Mediating Role of Patient Activation in the Association Between Illness Perception and Self-Management Behavior...

This study aimed to examine the relationships among illness perception, patient activation, and self-management behavior in oral cancer patients, and to explore the mediating role of patient activation between illness perception and self-management behavior.

A cross-sectional study was conducted among 220 oral cancer patients recruited from two tertiary hospitals in Shandong Province, China, using a convenience sampling method. Data were collected using the Brief Illness Perception Questionnaire (BIPQ), Patient Activation Measure (PAM), and the Cancer Patient Self-Management Scale. Pearson correlation analysis, multiple linear regression, and structural equation modeling (SEM) were performed to analyze the relationships among variables. The mediating effect was tested using the bootstrap method.

A total of 220 valid questionnaires were collected. The mean scores for illness perception, patient activation, and self-management behavior were 41.69±12.23, 59.17±12.81, and 133.71±35.95, respectively. Several demographic and clinical characteristics were associated with self-management behavior in the regression analysis. Negative illness perceptions were significantly associated with lower self-management behavior (r= -0.875,P<0.01), whereas patient activation was positively correlated with self-management behavior (r=0.882,P<0.01). Negative illness perceptions were also associated with lower patient activation (r=-0.896,P<0.01). Structural equation modeling showed that patient activation partially mediated the relationship between negative illness perceptions and self-management behavior (β=-0.53; 95% CI: -0.87 to -0.19), with the mediating effect accounting for 56.58% of the total effect.

Patient activation plays a significant mediating role in the relationship between negative illness perceptions and self-management behavior in oral cancer patients, accounting for 56.58% of the total effect. This finding suggests that enhancing patient activation may partially reduce the adverse impact of negative illness perceptions on self-management behavior and represents an important target for clinical interventions aimed at improving self-management among oral cancer patients.