{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:15:21Z","timestamp":1783574121702,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Objectives<\/jats:title>\n To test the relationship between nutritional literacy, self-efficacy, family support and cancer anorexic behavior among patients with gastrointestinal cancer undergoing chemotherapy. And examine the moderating role of family support on the relationship between nutritional literacy and self-efficacy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using convenience sampling, 248 patients with gastrointestinal cancer undergoing chemotherapy were recruited from the Oncology Center of a Grade A Level 3 general hospital in Henan Province, China, between June and November 2025. Data analysis was performed by SPSS 27.0, while PROCESS macro v5.0 was used to test the moderated mediation model.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Nutritional literacy mediated by self-efficacy was positively associated with anorexic behavior score (\n \u03b2<\/jats:italic>\n \u00a0=\u00a00.334,\n t<\/jats:italic>\n \u00a0=\u00a06.156,\n P<\/jats:italic>\n &lt;0.001). Family support played a positive moderating role in the relationship between nutritional literacy and self-efficacy (\n \u03b2<\/jats:italic>\n \u00a0=\u00a00.051,\n t<\/jats:italic>\n \u00a0=\u00a04.704,\n P<\/jats:italic>\n &lt;0.001). When family support was high, nutritional literacy had a stronger association with self-efficacy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study found that nutritional literacy among patients with gastrointestinal cancer is directly associated with cancer anorexic behavior and indirectly associated with it through self-efficacy. Furthermore, family support moderates the relationship between nutritional literacy and self-efficacy. Moving forward, interventions should be implemented on three fronts\u2014improving patients\u2019 nutritional literacy, strengthening their sense of self-efficacy, and enhancing family support systems\u2014to alleviate cancer-related anorexia, improve nutritional status, and enhance quality of life.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2026.1867483","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:22:09Z","timestamp":1783570929000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between nutritional literacy and cancer anorexia among gastrointestinal cancer patients: a moderated mediation analysis on the roles of self-efficacy and family support"],"prefix":"10.3389","volume":"16","author":[{"given":"Peiyao","family":"Zhu","sequence":"first","affiliation":[{"name":"School of Nursing and Health, Henan University","place":["Kaifeng, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Li","sequence":"additional","affiliation":[{"name":"Breast Surgery, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Henan Provincial People's Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengyu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Henan Provincial People's Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Cao","sequence":"additional","affiliation":[{"name":"Neurological Intensive Care Unit, Henan Provincial People's Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Guo","sequence":"additional","affiliation":[{"name":"Cancer Center, Henan Provincial People's Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(25)01635-6","article-title":"The global, regional, and national burden of cancer, 1990-2023, with forecasts to 2050: A systematic analysis for the global burden of disease study 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