Wang FZ, Xu JS, Sun H, Wang XL, Huang Y. Association between illness perception and depression in colorectal cancer patients: Chain mediating effects of self-efficacy and post-traumatic growth. World J Psychiatry 2026; 16(6): 119401 [DOI: 10.5498/wjp.v16.i6.119401]
Corresponding Author of This Article
Ye Huang, FRCS, Deputy Director, Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, No. 2 Section 5 Renmin Street, Guta District, Jinzhou 121000, Liaoning Province, China. huangy1@jzmu.edu.cn
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Psychology, Clinical
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Wang FZ, Xu JS, Sun H, Wang XL, Huang Y. Association between illness perception and depression in colorectal cancer patients: Chain mediating effects of self-efficacy and post-traumatic growth. World J Psychiatry 2026; 16(6): 119401 [DOI: 10.5498/wjp.v16.i6.119401]
World J Psychiatry. Jun 19, 2026; 16(6): 119401 Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.119401
Association between illness perception and depression in colorectal cancer patients: Chain mediating effects of self-efficacy and post-traumatic growth
Fu-Zhuo Wang, Jia-Shuang Xu, Hong Sun, Xiu-Li Wang, Ye Huang
Fu-Zhuo Wang, Ye Huang, Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
Jia-Shuang Xu, Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
Hong Sun, Department of Nursing, Liaoning Cancer Hospital and Institute, Shenyang 110801, Liaoning Province, China
Xiu-Li Wang, Department of Nephrology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
Co-first authors: Fu-Zhuo Wang and Jia-Shuang Xu.
Author contributions: Wang FZ and Xu JS conceived and designed the research, and they are the co-first authors of this manuscript; Wang FZ wrote the paper; Wang FZ and Xu JS analyzed the data; Wang FZ, Xu JS, Sun H, Wang XL, and Huang Y revised the paper; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the College of Nursing’s Research Committee at Jinzhou Medical University Institutional Review Board (approval No. JZMULL2023029), and all research methods strictly adhered to the principles of the Declaration of Helsinki.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at E-mail address: huangy1@jzmu.edu.cn.
Corresponding author: Ye Huang, FRCS, Deputy Director, Department of General Surgery, The First Affiliated Hospital of Jinzhou Medical University, No. 2 Section 5 Renmin Street, Guta District, Jinzhou 121000, Liaoning Province, China. huangy1@jzmu.edu.cn
Received: January 29, 2026 Revised: March 7, 2026 Accepted: April 10, 2026 Published online: June 19, 2026 Processing time: 122 Days and 2.3 Hours
Abstract
BACKGROUND
Illness perception is a known correlate of depression in cancer patients, yet the mechanisms explaining this association remain incompletely understood. Self-efficacy and post-traumatic growth represent two psychological resources that may explain the association between illness perceptions and depressive symptoms. Understanding these pathways could inform targeted interventions for colorectal cancer patients.
AIM
To investigate the mediating roles of self-efficacy and post-traumatic growth in the relationship between illness perception and depression among colorectal cancer patients.
METHODS
A cross-sectional study was conducted from May to November 2024 in two tertiary hospitals in Liaoning Province, China. A total of 290 colorectal cancer patients were recruited using multistage stratified sampling. Data were collected via questionnaires assessing demographic characteristics, illness perception (Brief Illness Perception Questionnaire), self-efficacy (General Self-Efficacy Scale), post-traumatic growth (Post-Traumatic Growth Inventory), and depression (Patient Health Questionnaire-9). Mediation analysis was performed using the PROCESS macro (model 6) with 5000 bootstrap samples.
RESULTS
Illness perception was positively associated with depression [β = 0.2575, 95% confidence interval (CI): 0.1827-0.3323]. Three significant mediating pathways were identified: (1) Via self-efficacy alone (β = 0.1099, 95%CI: 0.0700-0.1599), accounting for 27.47% of the total effect; (2) Via post-traumatic growth alone (β = 0.0275, 95%CI: 0.0014-0.0537), accounting for 6.80%; and (3) Via the sequential pathway of self-efficacy and post-traumatic growth (β = 0.0051, 95%CI: 0.0001-0.0122), accounting for 1.28%. The total indirect effect explained 35.63% of the variance.
CONCLUSION
Self-efficacy and post-traumatic growth mediate the relationship between illness perception and depression. Interventions targeting both cognitive appraisal and positive psychological growth may help mitigate depressive symptoms in this population.
Core Tip: This study reveals that self-efficacy and post-traumatic growth play a significant chain mediating role in the relationship between illness perception and depression among colorectal cancer patients. By enhancing patients’ self-efficacy and fostering post-traumatic growth, healthcare providers can effectively mitigate depressive symptoms, offering a dual-target intervention strategy that combines cognitive restructuring with psychological resource development.
