Social Support and Decision Fatigue in Breast Cancer Patients: A Chain Mediation Model of Psychological Resilience and Decision Self-Efficacy

Purpose This study aimed to examine the chain-mediating roles of psychological resilience and decision self-efficacy in the relationship between social support and decision fatigue among breast cancer patients, providing evidence for targeted interventions. Methods A convenience sample of 452 breast cancer patients was recruited from one hospital in China.Data were collected from January to May 2025 using Self-report questionnaires,including the demographic and clinical characteristics, Decision Fatigue Scale (DFS),Decision Self-Efficacy Scale (DSES) ,Social Support Rating Scale (SSRS), andConnor-Davidson Resilience Scale (CD-RISC). Data were analyzed using IBM SPSS 26.0 for descriptive and correlational analyses and AMOS 26.0 for mediation analysis. Results Decision fatigue was negatively correlated with social support (ρ = -0.280*), decision self-efficacy (ρ = -0.511), and psychological resilience (ρ = -0.533). Both psychological resilience and decision self-efficacy independently mediated the relationship between social support and decision fatigue, with a significant sequential mediation effect. The chain-mediating pathway accounted for 36.7% of the total effect of social support on decision fatigue. Conclusion Psychological resilience and decision self-efficacy serve as sequential mediators between social support and decision fatigue, highlighting their critical roles in mitigating decision-related exhaustion. These findings underscore the importance of integrated psychosocial support in clinical management.