Abstract: Objective To explore the mediating effect of perception of autonomy between death anxiety and self-supporting ability of rural elderly people. Methods The convenience sampling method was used to select the elderly from five villages in Taojiang County, Youxian County and Liling County in Hunan Province from July to September 2021 as the research object. A total of 350 subjects were investigated by using general information questionnaire, Simplified Chinese version of the PEA Scale, Death Anxiety Scale and Self-supporting Ability Questionnaire for Elderly People. The mediation model was constructed and verified. Results The total score of perception of autonomy, death anxiety and self-supporting ability of the rural elderly people was 58.12±7.89, 36.75±2.45 and 178.06±19.26 respectively. The total score of self-supporting ability was positively correlated with that of perception of autonomy (r=0.740, P<0.001),and negatively with that of death anxiety (r=-0.308, P<0.001).The total score of death anxiety was negatively correlated with that of perception of autonomy (r=-0.204, P<0.001). Perceived autonomy played a partial mediating role between death anxiety and self-supporting ability of the rural elderly people, with a mediating effect value of -0.120, accounting for 46.7% of the total. Conclusion In this study, the total score of death anxiety of the rural elderly is at a moderately low level, the total score of autonomy perception is at a medium level, and the total score of self-support ability is at a high level, and the perception of autonomy plays a partially mediating role between the self-supporting ability and death anxiety. It is suggested that medical workers pay attention to the attitude of rural elderly people towards death and enhance their perception of autonomy so as to improve their ability to support themselves.

Key words: the elderly, rural area, self-supporting ability, death anxiety, perception of autonomy, intermediary role