Relationship of Social Support and Coping Strategies with Post-Traumatic Growth and Functional Disability Among Patients with Cancer: Meditating Role of Health Literacy

Background: Psychological factors play important roles in mental and physical outcomes of cancer, like disability and positive growth after exposure to cancer trauma. Objectives: This study aimed to investigate the mediating role of health literacy in the relationship of social support and coping strategies with post-traumatic growth and functional disability among patients with cancer. Methods: The present descriptive, cross-sectional study included 265 patients (142women and 123 men) with various types of cancer selected by a convenience sampling method among patients referring to the Cancer Clinics of Imam Khomeini Hospital in Tehran, Iran. Data were collected by the “WHO Disability Assessment schedule”, “post-traumatic growth inventory”, “Functional, Communicative, and Critical Health Literacy scale”, “Social Support scale”, and “Brief Cope scale”. Data were analyzed by structural equation modeling (SEM) using AMOS-24 and SPSS-20 software. Results: The results showed that social support had a significant positive correlation with post-traumatic growth (P≤0.001) and health literacy (P≤0.001) and a significant negative correlation with functional disability (P≤0.001). There was a significant positive correlation between avoidance-coping strategies and post-traumatic growth (P≤0.001) and functional disability (P≤0.051). Problem-focused coping strategies had a significant positive correlation with health literacy (P≤0.051) and there was a significant negative correlation between health literacy and functional disability (P≤0.001). Additionally, health literacy had a mediating role in the relationship between social support and functional disability (P ≤ 0.001) and between problem-focused coping strategies and functional disability (P≤0.001). Conclusions: Social support and coping strategies directly or through the mediating role of health literacy are important predictors of post-traumatic growth and functional disability among patients with cancer, suggesting the need for intervening and educating in these areas to improve patients’ physical and mental status.