The relationship between health literacy and preoperative frailty in patients undergoing radical gastrectomy for gastric cancer:the chain mediating effect of psychological resilience and uncertainty in illness
ZHANG Xia
ZHOU Xingxing
FU Lei
GAO Yuan
GAO Caiyu
Abstract：Objective To explore the chain mediating effect of psychological resilience and uncertainty in illness on the relationship between health literacy and preoperative frailty in patients undergoing radical gastrectomy for gastric cancer.Methods Convenience sampling method was used to select a total of 224 patients with radical gastrectomy admitted to a hospital from June 2021 to March 2023 as the research objects.The general information questionnaire,Health Literacy Management Scale,Connor-Davidson Resilience Scale,Mishel Uncertainty Ill-ness Scale and Frailty Phenotype were used for investigation.Results The scores of health literacy,psychological resilience,uncertainty in illnessand and preoperative frailty of patients undergoing radical gastrectomy were(82.06±11.30),(57.92±8.81),(86.89±13.80),and 2(1,3),respectively.Correlation analysis showed that health literacy was positively correlated with psychological resilience(r=0.492,P＜0.0 1),and negatively correlated with uncertainty and preoperative frailty(r1=-0.604,r2=-0.768,P＜0.01).Psychological resilience was negatively correlated with uncertainty in illness and preoperative frailty(r1=-0.580,r2=-0.513,P＜0.01),and the uncertainty in illness was positively correlated with preoperative frailty(r=0.697,P＜0.01).The mediation model test showed that the direct effect of health literacy of patients undergoing radical gastrectomy on preoperative frailty was significant,with an effect value of-0.063,accounting for 68.48％of the to-tal effect.The mediating effect of psychological resilience and uncertainty in illness was significant,with effect values of-0.008 and-0.014,accounting for 8.70％and 15.22％of the total effect.The chain mediation effect of psychological resilience and uncertainty in illness was sig-nificant,with effect values of 0.007 respectively,accounting for 7.61％of the total effect.Conclusion The preoperative frailty of patients un-dergoing radical gastrectomy needs to be improved,and psychological resilience and uncertainty in illness play a chain mediating role between their health literacy and preoperative frailty.In the process of formulating health literacy intervention programs,clinical medical staff should pay attention to the mediating role of psychological resilience and uncertainty in illness to improve the frailty of patients.
Keywords：radical gastrectomy for gastric cancerfrailtyhealth literacypsychological resilienceuncertainty in illnesschain mediaton
Publication Date：2025-01-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 22-27 )