Impact of cancer-related fatigue on quality of life in patients with cancer - multiple mediating roles of psychological coherence and stigma

Sep 23, 2026

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Objective: Explore how cancer-related fatigue affects quality of life in cancer patients, and test the multiple mediating roles of psychological coherence and stigma. Methods: Cross-sectional survey administered between November 2022 and May 2023 to 364 patients in two tertiary hospitals in Jinzhou, Liaoning. Measures included general information, fatigue, psychological coherence, stigma, and quality of life; analyses used SPSS 25.0 and PROCESS 3.5 with mediation testing. Results: Fatigue showed a direct negative effect on quality of life and indirect effects via three mediators, totaling 30.50% mediation. Conclusion: Reducing fatigue while enhancing psychological coherence and lowering stigma may improve quality of life.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Abstract

Objective

Methods

Results

Conclusion

Background

Xu etal. BMC Cancer (2025) 25:64 BMC Cancer [https://doi.org/10.1186/s12885-025-13468-7](https://doi.org/10.1186/s12885-025-13468-7) RESEARCH Open Access Impact of cancer-related fatigue on quality of life in patients with cancer: multiple mediating roles of psychological coherence and stigma Jiashuang Xu 1, Qiang Li3, Ziyun Gao 1, Pengjuan Ji 1, Qiqi Ji 1, Miaojing Song 1, Yian Chen 1, Hong Sun4, Xin Wang5, Lin Zhang2* and Leilei Guo 1* Abstract Objective The goal of this current research was to explore the impact of cancer-related fatigue on the quality of life among patients with cancer, as well as the multiple mediating roles of psychological coherence and stigma. Methods This study utilized a cross-sectional design. A questionnaire was administered between November 2022 and May 2023 to 364 patients with cancer in two tertiary hospitals in Jinzhou City, Liaoning Province, China. The questionnaires included the General Information Questionnaire, Cancer-Related Fatigue Questionnaire, Psychological Coherence Scale, Stigma Scale, and Quality of Life Questionnaire. SPSS 25.0 and PROCESS 3.5 macros were used for descriptive statistics and correlation analysis of the data, as well as multiple mediation effect tests. Results Cancer-related fatigue directly affects quality of life (β = -0 . 950, 95% CI = -1.138 to-0 . 763) and indirectly through three mediators: psychological coherence (β = -0 . 172, 12. 58% of total effect), stigma (β = -0 . 193, 14. 12% of total effect), and both psychological coherence and stigma (β = -0 . 052, 3. 80% of total effect), totaling a 30. 50% mediating effect. Conclusion Overall, psychological coherence and stigma may play an important mediating role between cancerrelated fatigue and quality of life in patients with cancer. This suggests that alleviating cancer-related fatigue, while enhancing psychological coherence and reducing stigma, could be effective strategies for improving patients’ quality of life. Therefore, healthcare professional s and related professionals should pay attention to and adopt effective interventions to alleviate cancer-related fatigue, enhance psychological coherence, and reduce stigma, thereby contributing to the overall well-being and quality of life of patients with cancer. Keywords Patients with cancer, Cancer-related fatigue, Psychological coherence, Stigma, Quality of life *Correspondence: Lin Zhang [yaoran2008@163.com](yaoran2008@163.com)[ ](yaoran2008@163.com)Leilei Guo [guoleilei@jzmu.edu.cn](guoleilei@jzmu.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Xu et al. BMC Cancer (2025) 25:64 Background Cancer, as a serious health issue, impacts the lives of millions of persons annually. It not only poses a direct threat to the bodily health of patients with cancer but also exposes them to multiple psychological, social as well as quality-of-life cha

FAQs

What is the study’s main purpose?

To examine how cancer-related fatigue impacts quality of life in cancer patients and to evaluate whether psychological coherence and stigma mediate this relationship.

How was the study conducted?

A cross-sectional questionnaire survey was administered from November 2022 to May 2023 to 364 patients with cancer in two tertiary hospitals in Jinzhou, Liaoning.

What were the key mediation findings?

Cancer-related fatigue had a direct negative effect on quality of life and indirect effects through psychological coherence, stigma, and their combined pathway, accounting for a total mediating effect of 30.50%.

Sep 23, 2026

Uploaded by Himbo