Among 507 gastric cancer patients undergoing chemotherapy in a Chinese hospital, illness perception directly and indirectly influences self-transcendence through hope levels and coping styles. Patients' average illness perception score was 42.79, hope levels 34.10, confrontation coping 24.50, avoidance 20.69, yield 14.70, and self-transcendence 44.08. A random forest model ranked illness perception as most important, followed by avoidance, confrontation, hope levels, self-rated health, and yield. Mediation analysis showed illness perception had a direct effect on self-transcendence (about 55% across coping dimensions), with hope levels mediating about 31%, coping styles about 7%, and a chain mediation of hope and coping about 6%.
Gastric cancer patients undergoing chemotherapy have moderate-to-low self-transcendence, with an average score of 44.08 on the Self-Transcendence Scale. The five most important factors influencing self-transcendence are the degree of confrontation, self-rated health status, degree of resignation, level of hope, and degree of avoidance. These factors were identified using a random forest model and LASSO regression, then confirmed by multiple linear regression. Healthcare workers may improve patients' self-transcendence by targeting these factors, potentially enhancing quality of life during chemotherapy.