Illness Perception and Fear of Cancer Recurrence in Elderly Cance r Patients: The Chain Mediating Role of Self-Efficacy and Social S upport

Objective This study aims to investigate the relationship between illness perception and fear of cancer recurrence (FCR) in older adult cancer patients, as well as the mediating role of self-efficacy and social support in this association. The findings are intended to provide a theoretical foundation for developing targeted interventions to alleviate FCR in this demographic. Methods A total of 310 elderly cancer patients, admitted to the Oncology Department of three Grade A tertiary hospitals from January 2025 to August 2025,were selected through convenient sampling. The mean age of the 286 valid participants was 72.4 ± 7.7 years.Data were collected using the BriefIllness Perception Questionnaire, Fear of Cancer Recurrence Inventory, General Self-Efficacy Scale, and Social Support Rating Scale. Descriptive statistics, correlation analysis, and structural equation modeling were conducted usingSPSS 26.0 and AMOS 24.0 software. Results The study revealed that illness perception has a direct positive effect on FCR (β = 0.399, P < 0.001). Illness perception predicts FCR through two significant indirect pathways: the independent mediating effect of self-efficacy (β = 0.128, 95% CI: 0.078 ~ 0.182) and the chain mediating path of self-efficacy → social support (β = 0.083, 95% CI: 0.043 ~ 0.126). The independent mediating path of social support was not statistically significant (β = 0.000, 95% CI: -0.021 ~ 0.021). Conclusion The findings suggest that a more negative illness perception in older adult cancer patients is associated with higher levels of FCR. Self-efficacy and social support serve as chain mediators between illness perception and FCR. Clinically, addressing negative illness perceptions and enhancing self-efficacyand social support may effectively alleviate FCR and improve the mental health of older adult cancer patients.