| Objective:The purpose of this study was to investigate the current situation of fear of recurrence in breast cancer patients and to analyze its influencing factors.Meanwhile,the structural equation model is constructed based on the “Stress Coping Model” to analysis patients with breast cancer disease uncertainty social support and coping style to the role of the fear of cancer recurrence path,clear its interaction model,to provide a scientific theoretical basis and guidance for the formulation of intervention strategies and clinical health education for breast cancer patients with fear of cancer recurrence.Methods:1.A total of 325 cases of breast cancer patients in the department of breast surgery,chemotherapy and radiotherapy in a hospital in hebei province were investigated by using general data and disease-related data questionnaire,Fear of Progression Questionnaire Short Form(FoP-Q-SF),Mishel’s Uncertainty in illness Scale-Adult(MUIS-A),Perceived Social Support Scale(PSSS),Medical Coping Modes Questionnaire(MCMQ).2.Spss22.0 software is used to build the database and to analyze the data.Cronbach’s α was used to analyze the reliability of the questionnaire.Frequency,composition ratio,mean and standard deviation were used for statistical description.T-test and one-way anova were used to compare the fear of cancer recurrence among patients with different demographic characteristics and disease-related characteristics,P<0.05 means the difference is statistically significant.Pearson correlation analysis was used to analyze the correlation between fear score of cancer recurrence,sense of disease uncertainty score,social support score and coping style of breast cancer patients.3.With the “Stress Coping Model”as the theoretical framework,AMOS21.0 software was used to construct the structural equation model of influencing factors of cancer recurrence fear in breast cancer patients,and the model was fitted and modified to obtain the most reasonable structural equation model of influencing factors of cancer recurrence fear in breast cancer patients.Results:1.The overall average score of fear of cancer recurrence in breast cancer patients was 35.06±10.83 points,among which 175 patients with a total score ≥34,accounting for 53.8%..The fear of cancer recurrence score was divided into 215(66.15%)breast cancer patients with low level of fear of cancer recurrence,50(15.38%)patients with moderate level of fear of cancer recurrence,and 60(18.47%)patients with high level of fear of cancer recurrence.2.The results of univariate analysis showed that there were statistically significant differences in age,marital status,residence,occupation,education level,family income,medical expenses and tumor stage in the fear of cancer recurrence of the breast cancer patients(P<0.05).3.Pearson correlation analysis showed that the total score of fear of the cancer recurrence in breast cancer patients was positively correlated with the total score of disease uncertainty(P<0.01),with the correlation coefficient r=0.624.It was negatively correlated with the total score of social support(P<0.01),and the correlation coefficient r=-0.29.It was negatively correlated with the response score(P<0.01),and the correlation coefficient r=-0.245.It was positively correlated with the yield response score(P<0.01),and the correlation coefficient r=-0.51.4.The results of the structural equation model showed that the disease uncertainty of breast cancer patients had a direct positive effect on the fear of cancer recurrence(β=0.275,P<0.01)and an indirect positive effect(β =0.254,P<0.01).Social support had an indirect negative effect on the fear of cancer recurrence(β =-0.098,P<0.01).Yield response in coping style had a direct positive effect on fear of cancer recurrence(β=0.375,P<0.01).Conclusion:1.The fear of recurrence in breast cancer patients should not be ignored and medical staff should pay attention to it.2.Age,marital status,residence,occupation,education level,family income,medical payment method and disease stage are important factors influencing the fear of cancer recurrence in breast cancer patients.3.Disease uncertainty,social support,face coping and yield coping are related to the fear of cancer recurrence.Uncertainty was positively correlated with fear of cancer recurrence,social support was negatively correlated with fear of cancer recurrence,face coping was negatively correlated with the fear of cancer recurrence,and yield coping was positively correlated with fear of cancer recurrence.4.Structural equation model analysis shows that disease uncertainty has both direct and indirect effects on the fear of cancer recurrence.Social support has an indirect effect on the fear of cancer recurrence,while yield coping has a direct effect on the fear of cancer recurrence.Disease uncertainty and yield coping can directly affect the fear level of cancer recurrence.Therefore,the direct path to affect the fear level of cancer recurrence in breast cancer patients is: disease uncertainty → fear of cancer recurrence;yield coping → fear of cancer recurrence.In addition to the direct impact of disease uncertainty on the fear of cancer recurrence,it can also deal with the indirect impact through social support and yield coping.Therefore,the indirect path that affects the fear of recurrence of cancer in breast cancer patients is as follows: uncertainty of disease → social support → yield coping→ fear of recurrence of cancer;Disease uncertainty → yield coping → fear of cancer recurrence. |
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