Lawler Thomas, Kwekkeboom Kristine, Warren Andersen Shaneda, Sethi Ajay K, Tevaarwerk Amye J, Litzelman Kristin, Pophali Priyanka A, Gangnon Ronald E, Hampton John M, LoConte Noelle K, Trentham-Dietz Amy
Carbone Cancer Center, School of Medicine and Public Health, University of WI-Madison, Madison, WI, USA.
School of Nursing, University of WI-Madison, Madison, WI, USA.
Support Care Cancer. 2025 Sep 10;33(10):843. doi: 10.1007/s00520-025-09905-9.
For cancer survivors, self-efficacy is needed to manage the disease and the effects of treatment. The COVID-19 pandemic disrupted cancer-related healthcare, which may have impacted self-management self-efficacy. We investigated self-efficacy reported by cancer survivors during COVID-19, including associations with healthcare disruptions, distress, and general health.
Between 2020 and 2021, 1902 individuals aged 18-80 years with a recent cancer diagnosis completed a survey regarding the effects of COVID-19 on healthcare, self-efficacy for managing cancer and social interactions, cancer-related distress, and perceived general health. Linear and logistic models estimated odds ratios and 95% confidence intervals (CIs) between self-efficacy scores, healthcare disruptions, significant distress, and general health.
Mean self-efficacy for managing cancer was 7.58 out of 10. Greater self-efficacy was associated with lower odds for distress (OR 0.18 [95% CI 0.13-0.26], quartile 4 vs. 1) and for worse general health (0.05 [0.03-0.09]). Participants with disruptions to cancer-related healthcare had lower self-efficacy for managing cancer compared to those without (6.62 vs. 7.09, respectively, P < 0.001) and higher odds for distress (1.70 [1.36-2.14]), but not worse general health (1.13 [0.39-1.44]). Lower self-efficacy mediated 27% of the association between healthcare disruptions and increased distress (15-47%). Associations with self-efficacy for managing social interactions trended in the same direction.
During COVID-19, disruptions to cancer-related healthcare were associated with lower self-efficacy, increased distress, and worse general health. Psychosocial interventions designed to overcome barriers and target self-efficacy may be important for enhancing outcomes among cancer survivors experiencing disruptions in healthcare access.
对于癌症幸存者而言，管理疾病及治疗影响需要自我效能感。新冠疫情扰乱了癌症相关医疗保健，这可能对自我管理的自我效能感产生了影响。我们调查了新冠疫情期间癌症幸存者报告的自我效能感，包括其与医疗保健中断、痛苦和总体健康状况的关联。
在2020年至2021年期间，1902名年龄在18至80岁且近期被诊断患有癌症的个体完成了一项关于新冠疫情对医疗保健、癌症管理自我效能感和社交互动、癌症相关痛苦以及感知总体健康状况影响的调查。线性和逻辑模型估计了自我效能感得分、医疗保健中断、严重痛苦和总体健康状况之间的比值比及95%置信区间（CI）。
管理癌症的平均自我效能感为十分制中的7.58分。更高的自我效能感与更低的痛苦几率（四分位数4与1相比，比值比为0.18 [95% CI 0.13 - 0.26]）以及更差的总体健康状况几率（0.05 [0.03 - 0.09]）相关。与未经历癌症相关医疗保健中断的参与者相比，经历此类中断的参与者管理癌症的自我效能感更低（分别为6.62分和7.09分，P < 0.001），痛苦几率更高（1.70 [1.36 - 2.14]），但总体健康状况并无更差（1.13 [0.39 - 1.44]）。较低的自我效能感介导了医疗保健中断与痛苦增加之间27%的关联（15% - 47%）。与管理社交互动的自我效能感的关联也呈相同趋势。
在新冠疫情期间，癌症相关医疗保健的中断与更低的自我效能感、增加的痛苦以及更差的总体健康状况相关。旨在克服障碍并以自我效能感为目标的心理社会干预措施，对于改善医疗保健获取受限的癌症幸存者的结局可能至关重要。
