Analysis Of Influencing Factors Of Fear Disease Progression And Construction Of Risk Assessment Model In Patients With Colorectal Cancer

Objective(s):To investigate the level of FOP in colorectal cancer patients at different stages(T1,T2,T3)and its influencing factors,analyze its change trajectory,build a risk assessment model of FOP at different stages,help clinical nursing staff to identify the psychological imbalance of patients at different stages and provide risk assessment tools.In order to provide reference and basis for clinical nursing intervention.Methods:1.The stress process model was used as the theoretical guidance for the study on the influencing factors of FOP.Through the longitudinal study design,302 patients with colorectal cancer who met the Nanhua standard from two Grade A hospitals in Yunnan Province from January to October 2022 were selected by convenient sampling method for admission(T1),3 months(T2),6 months(T3)questionnaire survey,and the evaluation tool was adopted:(1)General Information Questionnaire,(2)Simplified Fear Disease Progression Scale(Fo P-Q-SF),(3)Perceptive Social Support Questionnaire(PSSS),(4)Psychological Resilience Scale(CD-RISC),(5)Medical Coping Style Questionnaire(MCMQ),(6)Simple Disease Perception Questionnaire(BIPQ).2.SPSS 26.0 software was used for statistical analysis: mean ± standard deviation,frequency and percentage were statistically described.The differences among demographic variables,disease-related variables,clinical indicators and fear disease progression were analyzed by nonparametric test.Spearman correlation analysis was used to analyze the correlation between clinical indicators,BIPQ,PSSS,CD-RISC,MCMQ and FOP-Q-SF at three different time points.Nonparametric rank sum test was used to study the change trend of FOP and its related influencing factors.Multiple linear regression was used to analyze the influencing factors of FOP at different time points,and the FOP risk assessment model was established.P < 0.05 was used in all tests,α=0.05 indicated statistically significant difference.Results:1.A total of 310 patients admitted to hospital(T1),303 patients at 3 months(T2),and 302 patients at 6 months(T3)were investigated.In this study,302 patients completed the whole process investigation,with a loss of follow-up rate of 2.58% and an effective recovery rate of 97.42%.2.The median and quartile distances of FOP at T1-T3 time points were 31.00(24.00,39.00),29.00(21.00,37.00),25.50(20.00,34.00),respectively.The median and quartile spacing of physiological health dimension were 17.00(13.00,20.00),16.00(12.00,19.00),14.00(11.00,18.00),respectively.The median and quartile spacing of social family dimension were 14.00(10.00,19.00),13.00(9.00,18.00)and 12.00(8.00,16.00),respectively.Changes at three time points: T3 fear disease progression/physical health/social family score < T2 fear disease progression/physical health/social family score < T1 fear disease progression/physical health/social family score;The number of people with mental imbalance in the T1-T3 stage accounted for41.40%,36.40% and 25.80% respectively.3.Nonparametric rank sum test and ppair comparative analysis analyzed the scores and changes of four mediating variables at three time points.The results showed that the median and quartile spacing of each intermediary variable from T1 to T3 in patients with colorectal cancer was as follows: Social support(T1 to T3): 65.00(57.00,70.00),66.00(59.00,71.00),69.00(62.00,75.00),T3 social support score > T2 social support score > T1 social support score;Psychological resilience(T1 to T3):57.00(49.00,65.00),59.00(51.00,67.30),61.00(53.00,69.00),T1 psychological resilience score < T2 psychological resilience score < T3 psychological resilience score;Disease perception(T1 to T3): 48.00(41.00,54.00),46.00(39.00,50.00),43.00(36.00,48.00),T1 disease perception score > T2 disease perception score > T3 disease perception score;Medical coping style(T1 to T3): 47.00(45.00,49.00),50.00(48.00,52.00),55.00(52.00,57.00),T1 coping style score < T2 coping style score <T3 coping style score.4.Nonparametric test on the progression of phobic disease progression in T1-T3 stage of colorectal cancer patients with different characteristics showed that:demographic variables,T1 and T2 stages: gender,age,education level,medical insurance type,T3 stage: gender,age,education level in different groups of patients were statistically significant(P<0.05);disease-related variables: disease stage,symptom distress,whether chronic disease was present,and whether there were signs of recurrence/metastasis at three time points,The difference was statistically significant in the comparison between different groups of patients(P<0.05).5.Spearman analysis conducted correlation analysis between the progression of fear disease and the dimensions of social support,mental resilience,disease perception and coping style in patients with colorectal cancer at T1-T3 stage.The results showed as follows: At T1,FOP score was positively correlated with avoidance(r=0.607),yield(r=0.595),disease awareness(r=0.425)and disease awareness(r=0.211)(P < 0.05).It was negatively correlated with family support(r=-0.457),outside family support(r=-0.548),tenacity(r=-0.426),self-reliance(r=-0.410),optimism(r=-0.139),facing(r=0.-708)and illness emotion(r=-0.151)(P < 0.05).FOP scores at T2 were positively correlated with avoidance(r=0.488),yield(r=0.486)and disease awareness(r=0.160)(P < 0.05).It was negatively correlated with family support(r=-0.453),family support(r=-0.541),tenacity(r=-0.430),self-improvement(r=-0.412),optimism(r=-0.131),and face(r=0.-617)(P < 0.05).FOP score in T3 stage was positively correlated with avoidance(r=0.503),yield(r=0.567)and disease awareness(r=0.160)(P < 0.05).It was negatively correlated with family support(r=-0.380),family support(r=-0.529),tenacity(r=-0.378),self-reliance(r=-0.383),optimism(r=-0.126),and facing(r=-0.568)(P < 0.05).6.Based on the results of multiple linear regression equations,an assessment model was established: Y1(FOP)=36.728-1.330* face +1.140* yield-0.283* family support +0.777* avoidance +0.109* disease awareness +0.308* disease awareness,which explained 73.90% of the total variation in fear disease progression.Y2(FOP)=61.794-1.144* Facing-0.355* outside family support +0.758* yielding-0.348* self-strengthening +0.665* avoidance-0.440* family support,accounting for63.90% of the total variation in fear disease progression.Y3(FOP)=34.592+1.423*yield-0.306* out-of-family support-0.744* Face +0.658* avoidance-0.426* family support,accounting for 57.60% of the total variation in fear disease progression.Conclusion(s):1.The progression of phobic diseases in the three time points of T1-T3 needs to be further improved,and the scores are generally at a medium level and show a downward trend,among which the scores of physiological health dimension are greater than those of social and family dimensions.The number of people with psychological imbalance in all three stages < 50%.2.Colorectal cancer patients at the three time points of T1-T3 have high social support and good psychological resilience,and can adopt more positive coping methods to cope with life stressful events,but the level of coping needs to be improved;The patient’s disease perception status is not good,indicating that the patient’s negative perception of the disease is still high,which needs to be paid attention to.3.Some demographic and disease-related data of different groups have differences in the scores of colorectal cancer patients who fear disease progression;The scores of phobic disease progression in T1-T3 stages were always positively and dynamically correlated with avoidance,yield,disease cognition,and disease understanding,and negatively correlated with family support,extra-family support,tenacity,self-improvement,optimism,face-to-face,and disease mood.4.The influencing factors of FOP in colorectal cancer patients changed at three time points.However,face,avoidance,and yield are the main influencing factors in the three stages,and the patient’s coping style can most affect his FOP level.In this study,a risk assessment model of FOP at different stages was constructed,which was operable,which had certain guiding significance for assessing the FOP level of patients at different stages and identifying high-risk groups.