The Impact of Intergenerational Support on Quality of Life in Elderly Patients with Advanced Lung Cancer in China: A Chain Mediation Model of Meaning in Life and Psychological Distress

Abstract Background This study explores the relationship between intergenerational support and quality of life (QoL) among elderly patients with advanced lung cancer, examining the dual perspectives of receiving and providing support. It further investigates the chained mediating effects of meaning in life and psychological distress. Methods A cross-sectional study was conducted from June to September 2025. A total of 300 elderly inpatients with advanced lung cancer were recruited from the oncology department of a tertiary hospital in Shanghai. Data were collected through paper-based questionnaires, including general demographic information, Parent-Child Social Support Questionnaire, Functional Assessment of Cancer Therapy–Lung (FACT-L), Meaning in Life Scale for Advanced Cancer Patients (MiLS), and the Distress Thermometer (DT). Descriptive statistics and Pearson correlations were performed using SPSS 27.0, and chained mediation analysis was conducted using Model 6 of PROCESS v5.0. Results Significant correlations were identified among received intergenerational support, provided intergenerational support, meaning in life, psychological distress, and QoL (all P < 0.01). Both received and provided intergenerational support had significant total effects on QoL (B = 0.232, SE = 0.075, 95% CI [0.084, 0.380]; B = 0.430, SE = 0.077, 95% CI [0.279, 0.581], respectively). Meaning in life and psychological distress significantly mediated this pathway. Conclusions Intergenerational support influences QoL through a chained mediation pathway involving meaning in life and psychological distress. Specifically, improving intergenerational interactions, fostering meaning in life, and reducing psychological distress collectively enhance QoL among elderly patients with advanced lung cancer.