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Research Article: The impact of illness perception on self-transcendence in gastric cancer patients undergoing chemotherapy: the chain mediating effect of hope levels and coping styles

Date Published: 2025-10-23

Abstract:
To investigate the current status of illness perception, hope levels, coping styles, and self-transcendence among gastric cancer patients undergoing chemotherapy, and to explore the chain-mediating role of hope levels and coping styles in illness perception and self-transcendence. This study is a cross-sectional study. A convenience sampling method was used to select 507 gastric cancer patients undergoing chemotherapy from a tertiary hospital in Wuxi City, China, from October 2024 to May 2025. A questionnaire survey was conducted using Demographic Characteristics Questionnaire, Brief Illness Perception Questionnaire, Herth Hope Index, Medical Coping Modes Questionnaire, and Self-Transcendence Scale. Data were analyzed by SPSS 27.0, R Studio and Amos 24.0. The mean scores for illness perception, hope levels, confrontation, avoidance, yield and self-transcendence were 42.79 ± 9.30, 34.10 ± 9.21, 24.50 ± 9.51, 20.69 ± 6.30, 14.70 ± 4.61 and 44.08 ± 10.38, respectively. The importance ranking of the random forest model was: illness perception, avoidance, confrontation, hope levels, self-rated health status and yield. The mediation model analysis indicated that illness perception had a significant direct effect on self-transcendence (confrontation, avoidance, and yield dimensions: 55.47%, 56.04%, 53.73%), the independent mediating effect of hope levels (30.90%, 32.13%, 32.05%), the independent mediating effect of coping styles (6.81%, 6.28%, 7.95%), and the chain mediating effect of hope levels and coping styles (6.81%, 5.85%, 6.27%). Illness perception directly influences self-transcendence in gastric cancer patients undergoing chemotherapy, indirectly influences self-transcendence through the mediating effects of hope levels, coping styles, and the chain mediating effect of hope levels and coping styles.

Introduction:
Gastric cancer is a prevalent and life-threatening disease globally and represents one of the leading causes of cancer-related mortality in the word. According to the latest data released by the International Agency for Research on Cancer (IARC) ( 1 ), gastric cancer accounted for over 968,000 new cases and approximately 660,000 deaths globally in 2022, ranking as the fifth most common cancer and a leading cause of cancer-related mortality worldwide. The disease usually be discovered at an advanced stage,…

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