{
  "abstract": "Objectives Although previous studies have examined the psychological benefits of physical activity in cancer survivors, the underlying psychological mechanisms among lung cancer survivors remain poorly understood. This study aims to examine the parallel mediating roles of social connection and self-efficacy in stress coping in the association between physical activity and psychological distress (anxiety and depression) among Chinese lung cancer survivors.Design A cross-sectional observational study.Setting A tertiary care hospital in Shanghai, China.Participants A total of 588 lung cancer survivors were recruited and assessed physical activity, anxiety, depression, social connection and self-efficacy in stress coping. Path analysis was conducted to examine the parallel mediating effects of social connection and self-efficacy in stress coping in the association between physical activity and psychological distress (anxiety and depression).Outcome measures The primary outcome was the examination of the mediating effects of social connection and self-efficacy in stress coping on the relationship between physical activity and psychological distress, assessed using path analysis.Results Social connection (p=0.003 for anxiety; p<0.001 for depression) and self-efficacy in stress coping (p<0.001 for anxiety; p<0.001 for depression) significantly mediated the association between physical activity and psychological distress. Physical activity was positively associated with social connection and self-efficacy in stress coping, both of which were negatively associated with anxiety and depression. After controlling for the mediators, the direct effects of physical activity on anxiety and depression were no longer significant.Conclusion These findings suggest that social connection and self-efficacy in stress coping may serve as critical psychological mechanisms underlying the association between physical activity and emotional well-being among Chinese lung cancer survivors. Interventions targeting anxiety and depression in lung cancer survivors may benefit from integrating strategies to enhance physical activity while promoting social connection and self-efficacy in coping to optimise psychological outcomes.",
  "authors": [
    {
      "affiliations": [
        "School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Jinhuan Yang"
    },
    {
      "affiliations": [
        "School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Rui Bao"
    },
    {
      "affiliations": [
        "Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Zhonglin Chen"
    },
    {
      "affiliations": [
        "Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Chenyan Han"
    },
    {
      "affiliations": [
        "Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Yi Zhao"
    },
    {
      "affiliations": [
        "Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Xiaomin Niu"
    },
    {
      "affiliations": [
        "School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Danni Dong"
    },
    {
      "affiliations": [
        "School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Yaping He"
    },
    {
      "affiliations": [
        "School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Qiao Chu"
    }
  ],
  "title": "Mediating roles of social connection and stress-coping self-efficacy in the association between physical activity and emotional distress among lung cancer survivors: a cross-sectional study",
  "uid": "8ffcc843-e6b8-50f1-ac36-0daefd9ebb4f"
}