【Abstract】Objective To investigate the correlation between self-management behavior and cancer-related fatigue (CRF) and quality of life in elderly survivors with lung cancer. Methods A total of 140 elderly patients with lung cancer admitted to the First Affiliated Hospital of Nanjing Medical University from March 2020 to June 2023 were included in the study and were followed up. The patients′ self-management behavior, CRF and quality of life were investigated using self-management behavior assessment scale for lung cancer survivors, Piper fatigue survey scale, and quality of life assessment scale (EORTC QLQC30). The influence of different demographic data on self-management behavior, CRF, and quality of life of patients was analyzed. SPSS 23.0 was used for statistical analysis. The statistical methods used included Pearson correlation analysis and mediation effect test. Data comparison between two groups was performed using t test, one-way analysis of variance or Chi-square test depending on data type. Pearson correlation analysis was used to analyze the correlation between self-management behavior, CRF and quality of life, and the mediating effect test was conducted using the mediating effect test procedure proposed by Wen Zhonglin. Results Among the 140 patients included in the study, 119 (85.00%) completed the questionnaire survey. The total score of self-management behavior was (122.83±23.47) points, at a moderate level. Of all the patients, 86 patients developed CRF (72.27%), with a total score of (131.43±34.41) points on the Piper Fatigue Survey Scale, indicating a moderate overall fatigue level. The total score of quality of life was (72.61±23.11) points. Statistically significant differences were found in self-management behavior scores between patients with different genders, whether living alone or not, educational levels, and monthly family incomes (all P<0.05). There were statistically significant differences in the CRF scores between patients with different ages, disease stages, whether undergoing surgery, whether undergoing chemotherapy, and different serum albumin levels (all P<0.05). The quality of life were significant different between patients with different ages, educational levels, monthly family incomes, number of comorbid chronic diseases, and disease stages (all P<0.05). Pearson correlation analysis showed that self-management behavior was negatively correlated with CRF (r=-0.346; P<0.001) and was positively correlated with quality of life (r=0.317; P<0.001). In addition, CRF was negatively correlated with quality of life (r=-0.285; P<0.001). Self-management behavior had a direct positive predictive effect on quality of life (β=0.465; P<0.001) and could also indirectly affect quality of life through the mediating effect of CRF, with the mediating effect accounting for 14.25% of the total effect. Conclusion The self-management behavior and quality of life are not high, and CRF is common among elderly survivors with lung cancer. The level of self-management can directly predict the quality of life and can also indirectly affect the quality of life through the mediating effect of CRF, improving the self-management behavior and enhancing the quality of life of elderly patients with lung cancer.
