{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T10:53:48Z","timestamp":1792493628442,"version":"4.5.0"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009558","name":"University Natural Science Research Project of Anhui Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009558","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the chain\u2010mediating roles of negative emotions and caregiver readiness between self\u2010efficacy and e\u2010health literacy among caregivers of patients with lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self\u2010Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests and a one\u2010way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The STROBE checklist was used for this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The total e\u2010health literacy score of caregivers of patients with lung cancer was 29.65\u2009\u00b1\u20097.11, and there was a correlation between self\u2010efficacy, negative emotions, caregiver readiness, and e\u2010health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain\u2010mediating roles between self\u2010efficacy and e\u2010health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Caregivers of patients with lung cancer exhibit moderate levels of e\u2010health literacy. This research suggests that self\u2010efficacy not only has a direct and positive influence on e\u2010health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.17807","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T23:26:12Z","timestamp":1747265172000},"page":"121-132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Self\u2010Efficacy and e\u2010Health Literacy Among Caregivers of Patients With Lung Cancer: The Chain\u2010Mediating Roles of Negative Emotions and Caregiver Readiness"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9329-1422","authenticated-orcid":false,"given":"Jiali","family":"Wu","sequence":"first","affiliation":[{"name":"School of Nursing Anhui Medical University  Hefei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congling","family":"Li","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of University of Science and Technology of China  Hefei 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