A Studty On The Relationship And Mediating Effect Between Fear Of Progression And Self-Management In Patients Undergoing Postoperative Chemotherapy For Breast Cancer

ObjectiveTo investigate the status quo of fear of progression,hope,coping style and self-management of breast cancer patients undergoing postoperative chemotherapy,and to analyze the influencing factors of fear of progression and self-management of breast cancer patients.To explore the relationship between fear of progression,hope level,coping style and self-management in breast cancer patients.To investigate the mediating role of hope level and coping style between fear of progression and self-management.In order to help breast cancer patients with postoperative chemotherapy to improve the fear of progression,improve the level of hope,change coping styles,and provide reference for the improvement of patients’ self-management level.MethodsIn this study,convenience sampling method was adopted to select breast cancer patients undergoing postoperative chemotherapy in 3 Grade A general hospitals in Henan Province from November 2020 to December 2021 as the research objects.The patients were investigated by general data questionnaire,Fear of Progression Questionnaire-Short Form,Herth Hope Index scale,Medical Coping Modes Questionnaire and self-management Scale of cancer patients.Epidata 3.1 software was used for data entry,and SPSS 21.0software was used for statistical analysis.Statistical methods include descriptive statistical analysis,single factor analysis,Pearson correlation analysis,multiple linear regression analysis,mediation effect analysis,etc.Results1.Descriptive analysis: A total of 346 subjects were included in this study.The scores of fear of progression,hope and self-management were(35.91±7.27),(34.23±3.66)and(155.36±15.12),respectively.The scores of coping style,avoidance style and yield style were(19.44±3.21),(17.08±2.72),(10.40±2.22),respectively.2.Analysis of demographic differences: there were statistically significant differences in fear of progression scores among breast cancer patients with different age,education level,medical insurance type,family per capita monthly income,family history and disease stage(P<0.05);However,there were significant differences in self-management scores of breast cancer patients with different education level,monthly income per family per capita and disease stage(P<0.05).3.Correlation analysis: the fear of progression score of breast cancer patients undergoing postoperative chemotherapy was significantly negatively correlated with hope,face coping style and self-management score(r=-0.703,P<0.01;r=-0.724,P<0.01;r=-0.597,P<0.01),and was significantly positively correlated with the scores of avoidance coping style and yield coping style(r=0.600,P<0.01;r=0.652,P<0.01);There was a significant positive correlation between the score of self-management and the score of hope and face coping style(r=0.587,P<0.01;r=0.635,P<0.01),and the score of self-management was negatively correlated with the scores of avoidance and yield coping style(r=-0.466,P<0.01;r =-0.501,P<0.01).4.Multiple linear regression analysis: The main influencing factors of self-management of breast cancer patients undergoing postoperative chemotherapy were family per capita monthly income,fear of progression,hope,face and yield coping style.5.Mediating effect analysis: Fear of progression can not only directly affect the self-management level of breast cancer patients after chemotherapy,but also indirectly affect their self-management level through the mediating and chain mediating effects of hope and coping style.(1)The mediating effect value of hope was-0.234,accounting for 39.20% of the total effect.(2)The mediating effects of face and yield were-0.290 and-0.083,accounting for 48.57% and 13.91% of the total effect,respectively.(3)The chain mediating effect of hope and face was-0.107,accounting for 17.92% of the total effect.(4)The chain mediating effect of hope and yield was-0.016,accounting for 2.68% of the total effect.ConclusionBreast cancer patients undergoing postoperative chemotherapy are more inclined to adopt the avoidance coping style,the patient’s fear of progression,hope,and self-management scores are all at a medium level.And there is a significant correlation between the each variables.In addition,self-management of breast cancer patients undergoing postoperative chemotherapy is influenced by several factors.Hope level and face coping style,hope level and yield coping style play a chain mediating role between fear of progression and self-management in breast cancer patients undergoing postoperative chemotherapy.Therefore,nursing staff should strengthen psychological assessment of breast cancer patients with a high degree of fear of progression,carry out psychological intervention in a timely manner,encourage patients to adopt positive coping styles to face the disease,and improve their level of hope and self-management behavior.