Correlations between anxiety/depression, self-efficacy, and social support in patients with gastric cancer and analysis of risk factors

Abstract

BACKGROUND

Patients with gastric cancer (GC) frequently experience notable psychological distress, which often manifests as anxiety and depression. Identifying key contributing factors is essential for developing effective interventions to improve mental health outcomes.

AIM

To investigate the relationships between anxiety/depression, self-efficacy, and social support in patients with GC and identified significant risk factors.

METHODS

We enrolled 124 patients with GC undergoing treatment at Chongqing University Cancer Hospital between May 2021 and May 2024. Information regarding the patients’ anxiety and depression evaluated by the hospital anxiety and depression scale (HADS), [including a subscale for anxiety (HADS-A) and a separate subscale for depression (HADS-D)] self-efficacy, measured by the general self-efficacy scale (GSES), and social support, assessed by the perceived social support scale (PSSS), was gathered. Relationships among HADS, GSES, and PSSS scores were determined through Pearson correlation analysis. Risk factors for anxiety and depression among patients with GC were identified using univariate and multivariate analyses, specifically binary logistic regression.

RESULTS

The obtained data demonstrated mild psychological distress (mean HADS-A: 8.74 ± 3.70; mean HADS-D: 10.26 ± 3.84), suboptimal self-efficacy levels (GSES: 17.81 ± 5.45), and moderate social support (PSSS: 56.27 ± 11.28). Correlational analysis revealed significant inverse relationships between psychological distress (anxiety and depression) and both social support and self-efficacy (P < 0.01), with self-efficacy showing a strong positive association with social support (P < 0.01). Univariate analysis revealed that gender, age, clinical stage, tumor size, GSES, and PSSS were closely associated with anxiety and depression in patients with GC. Multivariate logistic regression identified three independent predictors of these mood disturbances: Advanced age (≥ 60), large tumor size (≥ 3 cm), and diminished GSES scores (< 18).

CONCLUSION

Our findings suggest that patients with GC generally experience mild anxiety and depression, which are closely related to low self-efficacy and insufficient social support. Age, tumor size, and low self-efficacy are independent predictors of anxiety and depression. In clinical practice, psychosocial interventions should be integrated, with a focus on high-risk populations, to improve patients’ mental health.

Keywords: Gastric cancer; Anxiety; Depression; Self-efficacy; Social support; Risk factors

Core Tip: Focusing on patients with gastric cancer, this study investigates how anxiety, depression, self-efficacy, and social support interact, identifying key risk factors. The findings indicate a prevalence of mild anxiety depression symptoms among such patients, coupled with diminished self-efficacy and intermediate social support levels. Enhanced hospital anxiety and depression scale screening is recommended for high-risk subgroups (age ≥ 60, tumor ≥ 3 cm, general self-efficacy scale < 18) to improve psychological risk stratification and thus facilitate early intervention.