Positive emotions and chronic stress in lung cancer patients undergoing immunotherapy: Mediation by perceived life threat and coping strategies.

[BACKGROUND] Evidence suggests that positive emotions play a critical role in coping with chronic stress. However, the specific psychological mechanisms underlying the association between positive emotions and chronic stress in lung cancer patients undergoing immunotherapy remain unclear. This study aims to examine the mediating roles of perceived life threat and coping strategies in the relationship between positive emotions and chronic stress, based on the Revised Stress and Coping model.

[METHODS] This cross-sectional study included 322 lung cancer patients receiving immunotherapy. Positive emotions, perceived life threat, coping strategies, and chronic stress levels were assessed using the Positive Affect Scale, the Perceived Life Threat Scale, the Cancer Coping Modes Questionnaire, and the Perceived Stress Scale, respectively. Path analysis was conducted utilizing the PROCESS macro (Model 6) to explore the indirect associations among these variables.

[RESULTS] Positive emotions had a significant negative correlation with chronic stress. Path analyses indicated that positive emotions were indirectly associated with chronic stress through perceived life threat and coping strategies. Significant sequential indirect associations were observed via perceived life threat and specific coping strategies: avoidance and repression (indirect effect = -0.038, 95% CI [-0.059, -0.020]), resignation (indirect effect = -0.041, 95% CI [-0.073, -0.018]), and catharsis coping strategies (indirect effect = -0.026, 95% CI [-0.044, -0.010]).

[CONCLUSIONS] Perceived life threat and coping strategies were statistically associated with how positive emotions relate to chronic stress in lung cancer patients undergoing immunotherapy. These findings align with theoretical models and may inform potential intervention targets to support clinical nursing practice.