Synergistic Psychosocial Pathways Linking Resilience to Self-Efficacy in Lung Cancer Following Video-Assisted Thoracic Surgery: A Cross-Sectional Study

Background Recovery after video-assisted thoracic surgery (VATS) can involve pain, fatigue, distress, and reduced confidence in rehabilitation activities Objectives Guided by conservation of resources theory, this study examined associations between resilience and cancer-related self-care self-efficacy measured during early postoperative recovery, the indirect roles of social support and negative emotion, and whether social support moderated the resilience-self-efficacy association. Design A cross-sectional study. Settings One tertiary Grade A cancer hospital in South China Participants A convenience sample of 225 adults with primary lung cancer who underwent elective VATS was assessed on postoperative days 3 to 5 before discharge. Methods Participants completed a sociodemographic/clinical questionnaire and validated Chinese versions of the social support, cancer self-care self-efficacy, resilience, and negative emotion scales. Observed-variable serial mediation paths were estimated with 5,000 bootstrap resamples; moderation was examined with a resilience by social support interaction Results Resilience was positively associated with self-efficacy (B = 2.080, 95% CI 1.826 to 2.334). The indirect associations through social support (B = 0.118, 95% CI 0.024 to 0.212), negative emotion (B = 0.084, 95% CI 0.004 to 0.164), and both variables sequentially (B = 0.018, 95% CI 0.004 to 0.032) were statistically significant. The resilience by social support interaction was also significant (beta = 0.083, p = 0.010). Conclusions In this early postoperative sample, resilience, social support, negative emotion, and self-efficacy showed patterns consistent with the proposed resource-based model. Nursing strategies that assess and support these resources should be tested in longitudinal and interventional studies.