Work

The impact of death literacy on self-management behaviors in gastric cancer patients: the chain mediating role of psychological adaptation and cognitive reappraisal

Year: 2026

Type: article

Abstract: Background: Death literacy-defined as the knowledge, skills, and attitudes that enable individuals to understand, communicate, and act effectively on issues related to death, dying, and bereavement-plays an important role in cancer patients' psychological regulation and coping behaviors. However, empirical evidence linking death literacy to self-management behaviors in gastric cancer patients remains limited. Methods: This study employed a cross-sectional design and used convenience sampling to recruit 501 gastric cancer patients from three tertiary Grade A hospitals in Zhejiang Province between August and September 2025. All participants completed the Death Literacy Scale, Self-Management Scale, Psychological Adaptation Scale, and Cognitive Reappraisal Scale. Process Model 6 was used to analyze the chain mediating effects of psychological adaptation and cognitive reappraisal. Results: < 0.001). Bootstrapping analysis confirmed significant indirect effects via psychological adaptation [β = 0.109, SE = 0.037, 95% CI = (0.036, 0.181)] and cognitive reappraisal [β = 0.106, SE = 0.029, 95% CI = (0.054, 0.170)], as well as a significant sequential mediation pathway [β = 0.068, SE = 0.018, 95% CI = (0.031, 0.102)], jointly explaining 59.75% of the total effect. The results suggest that higher death literacy enhances psychological adaptation and facilitates positive emotion regulation, thereby promoting active and sustained self-management behaviors. Conclusions: Death literacy functions as a positive psychological resource contributing to adaptive coping and health management among gastric cancer patients. Strengthening patients' understanding and acceptance of death may improve psychological adaptation and cognitive reappraisal, ultimately fostering better self-management and quality of life.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2025.1735804

Authors: Minyi Shi, Chengxi Xia, Yuxin Ye

Institutions: Wenzhou Medical University, Taizhou First People's Hospital, Zhejiang Chinese Medical University, Tongde Hospital of Zhejiang Province

Language: English

Topic: Cancer survivorship and care

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801