Family Bonds at the End of Life: A Qualitative Study of Meaning Reconstruction Through Intergenerational Relationships Among Older Adults With Advanced Lung Cancer.

BACKGROUND: Older adults with advanced lung cancer often face physical decline, changes in family roles, and existential distress, which may prompt their exploration of meaning in life. In the context of China's family-oriented culture, intergenerational relationships may play an important role in patients' meaning-making processes. Therefore, an in-depth exploration is needed to understand how older adults with advanced lung cancer construct meaning in life through intergenerational interactions with their children. OBJECTIVE: This study aimed to explore the lived experiences of older adults with advanced lung cancer as they reconstruct meaning in life through intergenerational interactions and to understand the underlying psychosocial processes. METHODS: This study used a descriptive phenomenological research design. Purposive sampling was used to recruit older adults with advanced lung cancer who were hospitalized in the Oncology Department of a tertiary Grade A hospital in Shanghai, China, from June through September 2025. Semi-structured interviews were conducted, and Colaizzi's phenomenological method was used to analyze the interview data and identify themes. RESULTS: A total of 17 older adults with advanced lung cancer were interviewed, with a mean age of 69 years. Three themes were identified: (1) Triggers for the Search for Meaning in Life, comprising two subthemes: The Disruption of Established Life Routines and Existential Confusion; (2) Redefining Values in Relationships, comprising four subthemes: The Redefinition of Family Roles, The Psychological Tension Between Dependence and Self-Respect, Regaining Dignity and Worth Through Giving, and The Two-Way Experience of Giving and Receiving love; and (3) Integrating Meaning in Life, comprising two subthemes: Life Education Through Leading by Example, and The Continuation of the Spirit and the Passing Down of Responsibility. CONCLUSION: Meaning reconstruction among older adults with advanced lung cancer is not solely an individual psychological process but is continuously shaped and developed through intergenerational interactions. Family relationships provide not only emotional and caregiving support but also important psychological resources for maintaining patients' identity, dignity, and sense of continuity. In clinical practice, greater attention should be paid to family-centered psychosocial support to facilitate patients' meaningful role engagement and sense of value within intergenerational relationships and support positive psychological adaptation during the end-of-life stage.