Medical Coping as a Mediator Between Social Support and Illness Uncertainty in Cancer Patients Across Age Groups: A Mediation Analysis

Objective: To examine the mediating role of medical coping in the relationship between social support and illness uncertainty among patients with malignant tumors, and to explore differences across age groups. Methods: A secondary analysis was conducted using cross-sectional data from 905 hospitalized patients. Patient-reported outcomes were measured using the Mishel Uncertainty in Illness Scale–Adult, the Social Support Rating Scale, and the Medical Coping Modes Questionnaire. Pearson correlation analyses were conducted using SPSS version 25.0, and mediation effects were tested using the PROCESS macro with bootstrap resampling. Results: In the overall sample, medical coping partially mediated the relationship between social support and illness uncertainty (indirect effect: β = 0.177, SE = 0.061, bootstrap 95% CI 0.067, 0.306). Age-stratified analyses showed a full mediation effect in younger patients (β = 1.362, SE = 0.218, 95% CI 0.875, 1.737). In contrast, the mediation effects were weaker in middle-aged and older patients, accounting for only 2.96% and 17.65% of the total effect, respectively. These findings indicate that the mediating role of medical coping varies across age groups, with distinct patterns observed among younger, middle-aged, and older patients. Conclusion: In this cross-sectional sample, the results were statistically consistent with an indirect association between social support and illness uncertainty via medical coping, with age-related differences. Younger patients showed a stronger indirect association via coping, whereas middle-aged and older patients showed relatively stronger direct associations between social support and illness uncertainty. Keywords: neoplasms, uncertainty in illness, social support, adaptation, psychological, nursing care