The Mediating Role of Patient Activation in the Association Between Illness Perception and Self-Management Behavior Among Patients with Oral Cancer.

OBJECTIVE: This study aimed to examine the relationships among illness perception, patient activation, and self-management behavior in oral cancer patients, and to explore the mediating role of patient activation between illness perception and self-management behavior. METHODS: A cross-sectional study was conducted among 220 oral cancer patients recruited from two tertiary hospitals in Shandong Province, China, using a convenience sampling method. Data were collected using the Brief Illness Perception Questionnaire (BIPQ), Patient Activation Measure (PAM), and the Cancer Patient Self-Management Scale. Pearson correlation analysis, multiple linear regression, and structural equation modeling (SEM) were performed to analyze the relationships among variables. The mediating effect was tested using the bootstrap method. RESULTS: A total of 220 valid questionnaires were collected. The mean scores for illness perception, patient activation, and self-management behavior were 41.69±12.23, 59.17±12.81, and 133.71±35.95, respectively. Several demographic and clinical characteristics were associated with self-management behavior in the regression analysis. Negative illness perceptions were significantly associated with lower self-management behavior (r= -0.875,P<0.01), whereas patient activation was positively correlated with self-management behavior (r=0.882,P<0.01). Negative illness perceptions were also associated with lower patient activation (r=-0.896,P<0.01). Structural equation modeling showed that patient activation partially mediated the relationship between negative illness perceptions and self-management behavior (β=-0.53; 95% CI: -0.87 to -0.19), with the mediating effect accounting for 56.58% of the total effect. CONCLUSION: Patient activation plays a significant mediating role in the relationship between negative illness perceptions and self-management behavior in oral cancer patients, accounting for 56.58% of the total effect. This finding suggests that enhancing patient activation may partially reduce the adverse impact of negative illness perceptions on self-management behavior and represents an important target for clinical interventions aimed at improving self-management among oral cancer patients.