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The Mediating Role of Inner Strength in the Relationship Between Illness Perception and Self-Management in Older
Fangjia Shen1, Yinlou Ling2, Caixia Ke3
1School of Nursing, Sun Yat-sen University, Guangzhou 510000, China.
Abstract:
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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