Relationship of Social Support and Coping Strategies with Post-Traumatic Growth and Functional Disability Among Patients with Cancer: Meditating Role of Health Literacy

 Psychological factors play important roles in mental and physical outcomes of cancer, like disability and positive growth after exposure to cancer trauma.

 This study aimed to investigate the mediating role of health literacy in the relationship of social support and coping strategies with post-traumatic growth and functional disability among patients with cancer.

 The present descriptive, cross-sectional study included 265 patients (142 women and 123 men) with various types of cancer selected by a convenience sampling method among patients referring to the Cancer Clinics of Imam Khomeini Hospital in Tehran, Iran. Data were collected by the “WHO Disability Assessment schedule”, “post-traumatic growth inventory”, “Functional, Communicative, and Critical Health Literacy scale”, “Social Support scale”, and “Brief Cope scale”. Data were analyzed by structural equation modeling (SEM) using AMOS-24 and SPSS-20 software.

 The results showed that social support had a significant positive correlation with post-traumatic growth (P ≤ 0.001) and health literacy (P ≤ 0.001) and a significant negative correlation with functional disability (P ≤ 0.001). There was a significant positive correlation between avoidance-coping strategies and post-traumatic growth (P ≤ 0.001) and functional disability (P ≤ 0.051). Problem-focused coping strategies had a significant positive correlation with health literacy (P ≤ 0.051) and there was a significant negative correlation between health literacy and functional disability (P ≤ 0.001). Additionally, health literacy had a mediating role in the relationship between social support and functional disability (P ≤ 0.001) and between problem-focused coping strategies and functional disability (P ≤ 0.001).

 Social support and coping strategies directly or through the mediating role of health literacy are important predictors of post-traumatic growth and functional disability among patients with cancer, suggesting the need for intervening and educating in these areas to improve patients’ physical and mental status.