Mahmoud Zivari Rahman, Javad Siahmoshtei, Niloofar Mikaeili,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Early Maladaptive Schemas (EMSs) are pervasive cognitive patterns that can detrimentally affect the well-being of individuals with chronic illnesses. This study aimed to investigate the structural relationship between EMSs and Health-Related Quality of Life (HRQoL) in cancer patients, with a specific focus on the mediating role of health literacy.
Methods: This descriptive-analytical study utilized a correlational design based on Structural Equation Modeling (SEM). The statistical population comprised all cancer patients aged 20 to 60 years referring to private oncology centers in [City Name] in 2025. A total of 665 participants were recruited using convenience sampling. Data were collected using the Young Schema Questionnaire (YSQ), the Health Literacy for Iranian Adults (HELIA) questionnaire, and the Health-Related Quality of Life questionnaire. Data analysis was performed using SPSS (v.25) and AMOS (v.24) software, with the significance level set at 0.05.
Results: The path analysis revealed that EMSs had a significant direct negative effect on both health literacy (β =-0.85, P< 0.001) and HRQoL (β= -0.56, P<0.001). Conversely, health literacy showed a significant positive effect on HRQoL (β=0.51, P<0.001). Furthermore, health literacy significantly mediated the relationship between EMSs and HRQoL (β=0.26,P<0.001). The goodness-of-fit indices confirmed the model's optimal fit (X2/Df = 3.94, GFI = 0.913, IFI = 0.903, CFI = 0.901, RMSEA = 0.067)
Conclusion: The findings suggest that Early Maladaptive Schemas significantly compromise the quality of life in cancer patients. However, health literacy acts as a protective buffer, mediating this negative impact. Therefore, interventions aimed at enhancing health literacy could be an effective strategy to mitigate the adverse effects of maladaptive schemas and improve the HRQoL of cancer patients.
