Relationships among social support, decision self-efficacy, and decision regret in colorectal chemotherapy cancer patients: A mediating model

TL;DR

This study explores how social support and decision self-efficacy affect decision regret in colorectal cancer patients undergoing chemotherapy in China.

Contribution

The study identifies decision self-efficacy as a mediator between social support and decision regret in chemotherapy patients.

Findings

Social support is negatively associated with decision regret in colorectal cancer patients.

Decision self-efficacy mediates 47.24% of the effect of social support on decision regret.

Lower income, limited employment, and lower education are linked to higher decision regret.

Abstract

This study aims to identify the factors associated with decision regret among colorectal cancer patients undergoing chemotherapy in China and to determine whether decision self-efficacy mediates the relationship between social support and decision regret.

A cross-sectional study was conducted using convenience sampling with 243 colorectal cancer patients receiving chemotherapy. From 29 July 2025–2 October 2025., all participants were recruited from a tertiary hospital in Inner Mongolia, China. Data were collected through a sociodemographic and clinical questionnaire, the Social Support Scale, the Decision Self-Efficacy Scale, and the Three-Dimensional Decision Regret Scale. Non-parametric tests were employed to analyze associated factors, and mediation analysis was performed using SPSS and AMOS.

Educational attainment, occupational status, and monthly income were significantly associated with decision regret among patients. Further analysis revealed a negative association between social support and decision regret in individuals undergoing chemotherapy for colorectal cancer (β = –0.306, p < 0.001). Path estimates showed that social support was positively associated with decision self-efficacy (β = 0.471, p < 0.001), while decision self-efficacy was negatively associated with decision regret (β = –0.581, p < 0.001). Decision self-efficacy functioned as a mediator linking social support to decision regret, producing an indirect effect of –0.273, which accounted for 47.24% of the total effect.

Notable interactions were observed among social support, decision self-efficacy, and decision regret, with decision self-efficacy serving as the mediating mechanism. Clinicians are encouraged to prioritize strengthening both external social support and patients’ internal decision self-efficacy, which were associated with lower decision regret and better quality of life. Additionally, particular attention should be directed toward individuals with lower income, limited employment, or lower educational attainment, as they demonstrate a heightened vulnerability to experiencing decision regret.

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