Stronger Minds, Better Lives: Exercise Self-Efficacy and Resilience as Serial Mediators in Oncology Nurses

Abstract

Background: Oncology nurses are highly vulnerable to impaired mental health and reduced quality of life due to the emotionally demanding nature of their work. Although mental health is a well-established determinant of quality of life, the mechanisms underlying this relationship remain insufficiently understood. Objective: This study examined the effect of the mental health continuum on quality of life among oncology nurses and tested the serial mediating roles of exercise self-efficacy and psychological resilience. Methods: A cross-sectional design was conducted with 604 oncology nurses in Türkiye. Data were collected using the Mental Health Continuum—Short Form, the Exercise Self-Efficacy Scale, the Psychological Resilience Scale, and the WHOQOL-BREF. Serial mediation analysis was performed using PROCESS Model 6 with 5000 bootstrap resamples. Results: The mental health continuum had a significant positive effect on exercise self-efficacy (a1 = 0.08, p < 0.001) and psychological resilience (a2 = 0.05, p < 0.001). Exercise self-efficacy significantly predicted psychological resilience (d1 = 0.51, p < 0.001). Both exercise self-efficacy (b1 = 0.88, p < 0.001) and psychological resilience (b2 = 1.60, p < 0.001) were significant predictors of quality of life. The direct effect of the mental health continuum on quality of life remained significant (c′ = 0.65, p < 0.001), indicating partial mediation. Bootstrap results further confirmed that all indirect effects were statistically significant, as their 95% confidence intervals did not include zero. Conclusions: Quality of life is influenced not only by mental health but also by sequential cognitive and adaptive processes. Interventions targeting exercise self-efficacy and psychological resilience may enhance well-being among oncology nurses.