Research Article: Food and nutrition literacy and diet self-efficacy among patients with liver cancer: latent profile analysis, associated factors, and an exploratory examination of gender differences
Abstract:
Patients with liver cancer frequently experience a heightened risk of malnutrition and a substantial symptom burden attributable to antitumor treatment. Food and nutrition literacy and diet self-efficacy represent critical psychobehavioral competencies that underpin dietary decision-making and the sustained adoption of healthy eating practices in this population. Nevertheless, few studies have delineated the latent profile typologies of these two constructs or their associated factors, and preliminary gender-stratified explorations remain conspicuously absent. To address these gaps, the present study employed a cross-sectional survey design, recruiting a convenience sample of 456 patients with liver cancer from three tertiary-level hospitals between April and October 2025. Data were collected using the Food and Nutrition Literacy Questionnaire, the Diet Self-Efficacy Scale, the Cancer Fatigue Scale, and the Social Support Scale. Results indicated that the optimal model for the full sample yielded a two-profile solution: a “Low Food and Nutrition Literacy–Low Diet Self-Efficacy” profile (47.37%) and a “High Food and Nutrition Literacy–High Diet Self-Efficacy” profile (52.63%). As an exploratory supplementary analysis, gender-stratified latent profile analyses were conducted; however, the substantial reduction in subgroup sample sizes following stratification by sex precluded the identification of statistically robust optimal profile solutions for either male or female subsamples. Binary logistic regression revealed that cancer-related fatigue constituted an independent risk factor for membership in the low-level profile, whereas social support served as an independent protective factor. Educational attainment, place of residence, and monthly personal income also exhibited partially significant predictive effects. Accordingly, clinical nutrition interventions should prioritize fatigue management and the reinforcement of social support, and stratified, precision-targeted interventions should be implemented on the basis of patients’ nutritional behavioral competency profiles.
Introduction:
Liver cancer ranks among the most prevalent and lethal gastrointestinal malignancies worldwide ( 1 , 2 ). According to the Global Cancer Statistics 2022 report, approximately 865,000 new cases of liver cancer and 758,000 liver cancer–related deaths were recorded globally, with China alone accounting for over 50% of incident cases ( 3 , 4 ). Previous research has established that the etiology of liver cancer is closely linked to chronic hepatitis B virus infection, hepatitis C virus infection, alcoholic liver…
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