# Exploring the Core Attributes of Quality of Life Among Low-Income Terminal Cancer Patients in China: A Network Analysis

## TL;DR

This study explores what factors most affect the quality of life for low-income terminal cancer patients in China, using network analysis to identify key attributes.

## Contribution

The study identifies 'attitudes towards treatment' and 'illness perception' as central factors in quality of life for terminal cancer patients, stratified by survival time.

## Key findings

- For patients surviving 3–6 months, 'attitudes towards treatment' had the highest centrality score.
- For patients surviving less than 3 months, 'illness perception' had the highest centrality score.
- 'Illness perception' and 'attitudes towards treatment' showed the strongest correlations in both groups.

## Abstract

Background/Objectives: Increasing evidence has shown that terminal cancer patients experience a poor quality of life (QoL), but the complex internal structure of the QoL among terminal cancer patients is not well documented. This study aimed to explore the core attributes of QoL and their interrelationships in low-income terminal cancer patients stratified by survival time (<3 months vs. 3–6 months). Methods: This study retrospectively analyzed the records of 5649 low-income terminal cancer patients from a hospital hospice center. The Cancer Pain and Quality of Life Questionnaire for Chinese Cancer Patients (CPQLQ) was employed to assess the QoL. A network analysis was conducted to examine centrality indices and density measures. Results: For patients with a survival time of 3 to 6 months, the highest centrality score was associated with “attitudes towards treatment” of the CPQLQ (rs = 1.84). In contrast, for those with a survival time of less than 3 months, “illness perception” of the CPQLQ had the highest centrality score (rs = 1.70). In both the less than 3 months and 3–6 months survival time groups, the network analysis indicated that the strongest correlations were between “illness perception” and “attitudes towards treatment” of the CPQLQ. Conclusions: Attitudes towards treatment and illness perception emerge as core attributes of the QoL network and are strongly interrelated among low-income terminally ill cancer patients. The findings highlight that a shift in hospice care priorities, linked to survival time, is crucial for enhancing the QoL of terminal cancer patients.