Objective: To analyze the mediating effect of psychological flexibility between death anxiety and quality of life in cancer patients. Methods: A convenience sampling method was used to select cancer patients who received treatment at our hospital from January 2022 to January 2024, by the inclusion and exclusion criteria. General information, psychological flexibility, death anxiety, and quality of life scores were collected for analysis. Result: The psychological flexibility and quality of life scores of cancer patients with an annual family income ≤ 100,000 RMB were significantly lower than those of cancer patients with an annual family income > 100,000 RMB (P < 0.05), while the death anxiety scores were significantly lower for the former group as well (P < 0.05). Cancer patients staged as I-II had significantly higher psychological flexibility and quality of life scores than those staged as III-IV (P < 0.05), while their death anxiety scores were significantly lower (P < 0.05). Psychological flexibility in cancer patients was negatively correlated with death anxiety (r = -0.614, P < 0.05) and positively correlated with quality of life (r = 0.628, P < 0.05), while death anxiety was negatively correlated with quality of life (r = -0.112, P < 0.05). The direct effect of death anxiety on quality of life was -0.232, accounting for 58.32% of the total effect. The mediating effect of psychological flexibility between death anxiety and quality of life was -0.218, accounting for 41.83% of the total effect. Conclusion: Death anxiety can directly affect the quality of life of cancer patients, and it can also indirectly affect the quality of life through psychological flexibility. Clinicians should promptly address patients’ death anxiety and provide interventions to enhance psychological flexibility, thereby improving the quality of life.
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