| ObjectiveThe purpose of this study was to investigate the symptom clusters,fear of disease progression and quality of life among patients with ovarian cancer who undergoing chemotherapy.And in this study we explored the mediating effect of fear disease progression between symptom clusters and quality of life by analyzing the correlation between symptom clusters,fear disease progression and quality of life in these patients to provide a basis for developing interventions to improve the quality of life in patients with ovarian cancer.MethodsWe recruited 366 ovarian cancer patients who had finished their first chemotherapy and from inpatient department of one provincial hospitals in Qingdao by convenience sampling between February 2021 to February 2022.A geneal data questionnaire,the Trait Emotional Intelligence Questionnaire-Short Form,Fear of Progression Questionnaire-Short Form,and Functional Assessment of Cancer Therapy-Ovarian were used for investigation.SPSS26.0 and AMOS24.0 software were used for statistical analysis of the survey data.The counting data were described by frequency and composition ratio,and the measurement data were described by mean ± standard deviation.Exploratory factor analysis was used to extract symptom clusters of ovarian cancer patients who underwent chemotherapy.The influence of general demographic data on quality of life of was analyzed by independent sample T test or one-way an OVA.Pearson’s correlation analysis was applied to analyse the correlations among symptom clusters,fear disease progression and quality of life.Hierarchical multiple regression analysis was conducted to explore the influencing factors of quality of life in patients with ovarian cancer chemotherapy.The mediating effect of fear disease progression on symptom clusters and quality of life was validated using structural equation models.Results1.The FACT-O score of quality of life was(92.23±18.21)among the patients with ovarian cancer,the score of physiological support was(17.66±5.46),the score of social and family status was(20.88±3.91),the score of emotional status was(14.74±4.19),the score of functional status was(14.09±4.83),and the score of additional attention was(24.86±6.88).The score of fear of disease progression in patients was(39.45±8.07),in which the score of physiological health dimension was(21.80±5.31)and the score of social family dimension was(17.66±4.62).2.The number of symptoms with its incidence greater than or equal to 20% in these patients was 18.Exploratory factor analysis was performed among the symptoms with incidence greater than or equal to 20%,and five major symptom clusters were extracted including digestive tract symptom clusters,impaired self-image symptom clusters,perimenopausal symptom clusters,psychological symptom clusters and pain-related symptom clusters.3.Pearson correlation analysis showed that severity of symptom clusters was negatively correlated with quality of life(R=-0.380,P<0.01).There was a significant positive correlation between severity of symptom clusters and fear disease progression(R=0.302,P<0.01).Fear of disease progression was negatively associated with quality of life(R=-0.444,P<0.01).4.Multiple linear regression analysis showed that the influencing factors for quality of life were age,education level,family economic status,tumor metastasis,chronic diseases,severity of symptom clusters and fear of disease progression among ovarian cancer patients receiving chemotherapy(P<0.05).5.The results of structural equation model showed that the total effect of symptom clusters on quality of life was-0.594.Symptom clusters affected the quality of life of patients and the direct effect value was-0.373.Symptom clusters affected the quality of life of patients through the mediating effect of fear of disease progression with an indirect effect value of-0.221.All factors reached significant level(P<0.01).The mediating effect accounted for 37.21% of the total effect.Conclusion1.Symptom clusters and fear of disease progression were negatively correlated with quality of life in ovarian cancer patients undergoing chemotherapy.Symptom clusters could directly affect patients’ quality of life,And symptom clusters indirectly affect patients’ quality of life through fear of disease progression,which played a significant intermediary role between symptom clusters and quality of life.2.The influencing factors of the quality of life of ovarian cancer patients undergoing chemotherapy included age,education level,family economic status,tumor metastasis,chronic disease,severity of the symptom clusters,and fear of disease progression. |
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