Psychological Capital and Quality of Life Among Cancer Survivors: The Mediating Role of Post-Traumatic Growth and the Moderating Role of Fear of Recurrence
Keywords:
Psychological capital, quality of life, cancer survivors, post-traumatic growth, fear of cancer recurrence, moderated mediationAbstract
Objective: This study aimed to examine the relationship between psychological capital and quality of life among cancer survivors in Brazil, with post-traumatic growth as a mediating variable and fear of cancer recurrence as a moderating variable.
Methods and Materials: This descriptive-correlational cross-sectional study was conducted among 384 adult cancer survivors in Brazil who had completed the main phase of cancer treatment and were receiving follow-up or survivorship care. Participants completed standardized self-report measures assessing psychological capital, post-traumatic growth, fear of cancer recurrence, and quality of life. Data were analyzed using SPSS and AMOS. Pearson correlation coefficients were used to examine relationships among the main variables. Mediation was tested through bootstrapping with 5,000 resamples, and moderation and moderated mediation effects were examined using interaction terms and conditional effect analysis. Model fit was evaluated using χ², CFI, TLI, RMSEA, and SRMR indices.
Findings: Psychological capital was significantly and positively associated with post-traumatic growth (β = 0.45, p < 0.001) and quality of life (β = 0.36, p < 0.001). Post-traumatic growth also had a significant positive effect on quality of life (β = 0.20, p < 0.001). The indirect effect of psychological capital on quality of life through post-traumatic growth was significant (B = 0.10, 95% CI [0.05, 0.16]), indicating partial mediation. Fear of cancer recurrence had a significant negative effect on quality of life (β = -0.42, p < 0.001) and significantly moderated the direct path between psychological capital and quality of life (β = -0.16, p = 0.001) and the path between post-traumatic growth and quality of life (β = -0.12, p = 0.009). The index of moderated mediation was significant (B = -0.002, 95% CI [-0.004, -0.001]).
Conclusion: Psychological capital was associated with better quality of life among cancer survivors both directly and indirectly through post-traumatic growth, while fear of recurrence weakened these positive pathways. These findings highlight the importance of integrating positive psychological resource enhancement with fear-of-recurrence management in survivorship care.
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Copyright (c) 2026 Yanelis Batista (Author); Thiago Moreira
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