Key result
Inner strength partially mediates the link between self-management and illness perception in advanced lung cancer.
Why the study?
This study aimed to investigate the associations between inner strength, illness perception, and self-management in older adults with advanced lung cancer.
Cross-Sectional (n=222)
Effect estimate: β -0.120 (NIP) and 0.132 (PIP) (95% CI -0.234 to -0.013 (NIP) and 0.011 to 0.246 (PIP))
p-value: p=0.032 (NIP) and 0.028 (PIP)
Inner strength plays a significant mediating role in the relationship between illness perception and self-management in older adults with advanced lung cancer.
Inner strength may warrant focus in self-management programs for cardiac patients; leaves open causality, needing longitudinal validation before adoption.
Objectives: This study aimed to investigate the associations between inner strength (IS), illness perception (IP) and self-management (SM) in older adults with advanced lung cancer. Methods: A cross-sectional survey was conducted with 222 patients recruited via convenience sampling between December 2021 and February 2023. SM, IP, and IS were measured using the Cancer Self-Management Assessment Scale, the Revised Illness Perception Questionnaire for lung cancer patients, and the Inner Strength Scale. Data were analyzed using descriptive statistics, Pearson correlation analysis, and structural equation modeling (SEM). Results: Participants exhibited moderate levels of SM, with the lowest scores observed for the symptom management dimension. Both SM and IS were negatively associated with negative illness perception (NIP) (rSM: −0.500, −0.149, p < 0.05; rIS: −0.519, −0.250, p < 0.001), and positively associated with positive illness perception (PIP) (rSM: 0.360, 0.565, p < 0.001; rIS: 0.233, 0.467, p < 0.001). Among the various dimensions of IP, personal control (representing PIP) and emotional representations (representing NIP) exhibited the strongest associations with SM (rPIP = 0.565, p < 0.001; rNIP = −0.500, p < 0.001). A positive relationship was observed between SM and IS (r = 0.427, p < 0.001). SEM indicated that IS partially mediated the associations between SM and both NIP and PIP (βNIP = −0.120, 95%CINIP: −0.234, −0.013, p = 0.032; βPIP = 0.132, 95%CIPIP: 0.011, 0.246, p = 0.028). Conclusions: The SM of older adults with advanced lung cancer remains suboptimal. IS may play an important mediating role in the association of both NIP and PIP with SM. These findings highlight that both IP and IS are key factors associated with SM in older adults with advanced lung cancer. Therefore, future research and clinical interventions should target these factors to improve SM in this population.
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Shen et al. (2026) conducted a cross-sectional in advanced lung cancer (n=222). Inner strength partially mediated the associations between self-management and both negative (β=-0.120, p=0.032) and positive (β=0.132, p=0.028) illness perception in advanced lung cancer.
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