Network analysis of quality of life among young and middle-aged Korean cancer survivors.

Objective: This study aimed to identify and compare the network structure of quality of life factors among cancer survivors to inform tailored interventions. Methods: A cross-sectional study was conducted using data from 330 cancer survivors aged 18-64 years, drawn from the 2019-2021 Korea National Health and Nutrition Examination Survey (KNHANES). Participants were categorized into two groups: cancer survivors with current cancer and those without. Network analysis using the EBICglasso algorithm was performed to assess eight quality of life (QoL) components measured by the Health-related Quality of Life Instrument with 8 Items (HINT-8) scale: climbing stairs, pain, vitality, work ability, depression, memory, sleep quality, and happiness. Results: The network analysis revealed distinct patterns between the two groups. Among survivors with current cancer, depression, work ability, and vitality were the most central QoL components, suggesting a need for targeted psychological and occupational support. In contrast, survivors without current cancer exhibited a network where work ability, pain, and climbing stairs (physical function) played a dominant role, emphasizing the importance of pain management and functional rehabilitation. Work ability emerged as a critical determinant in both groups, indicating its sustained impact throughout the survivorship continuum. Additionally, the network structure in survivors without current cancer showed greater interconnectedness, reflecting the complex interplay of long-term survivorship challenges. Conclusions: The study highlights the need for personalized, stage-specific interventions in cancer survivorship. Work remained central in both groups, emphasizing its ongoing impact on quality of life throughout the survivorship journey. While psychological support is crucial to cancer survivors with current cancer due to the centrality of depression, long-term pain management becomes increasingly important post-treatment. These findings provide valuable insights for nursing practice, suggesting that tailored interventions addressing work-related challenges, psychological distress, and chronic symptom management could improve quality of life and facilitate survivors' reintegration into daily life.