ABSTRACT
BackgroundQuality of life， as a major criterion for judging the clinical outcome of ovarian cancer patients， can be affected by adverse psychological symptoms of patients. Meanwhile， fear of disease progression， as a frequent psychological symptom among cancer survivors， is significantly influenced by metacognition， while there is a paucity of research into the specific correlation among the three in patients with ovarian cancer. ObjectiveTo explore the correlation among fear of disease progression， metacognition and quality of life in patients with ovarian cancer， and to test the role of fear of disease progression in the relationship between metacognition and quality of life， so as to provide references for improving the quality of life in patients with ovarian cancer. MethodsA total of 135 patients with ovarian cancer hospitalized in Cangzhou People's Hospital of Hebei Province from January 2019 to December 2022 were selected. All subjects were requested to complete the Functional Assessment of Cancer Therapy-Ovarian Cancer （FACT-O）， Fear of Progression Questionnaire-Short Form （FoP-Q-SF） and Metacognition Questionnaire （MCQ） to assess their quality of life， fear of disease progression and metacognitive level. Pearson correlation analysis was adopted to examine the correlation among the above scales. Process v3.5 macro program was utilized to determine the mediating effect of fear of disease progression on the relationship between metacognition and quality of life， and nonparametric Bootstrap with bias-correction was used to test the mediating effect. ResultsA total of 122 patients （90.37%） with ovarian cancer completed the effective questionnaire survey. Patients scored （90.52±17.13） on FACT-O， （68.52±16.31） on MCQ， and （37.72±8.91） on FoP-Q-SF. Pearson correlation analysis denoted that FoP-Q-SF score was negatively correlated with FACT-O score （r=-0.412， P<0.05） and positively correlated with MCQ score （r=0.241， P<0.05）， and MCQ score was negatively correlated with FACT-O score （r=-0.453， P<0.05）. Analysis demonstrated that the total effect of metacognition on quality of life was -0.298 （95% CI： -0.402~-0.186）. The direct effect of metacognition on quality of life was -0.219 （95% CI： -0.504~-0.277）， accounting for 73.49% of the total effect， and the indirect effect of metacognition on quality of life via fear of disease progression was -0.079 （95% CI： -0.162~-0.037）， accounting for 26.51% of the total effect. ConclusionQuality of life is reduced in patients with ovarian cancer， and fear of disease progression plays a partial mediating role in the relationship between metacognition and quality of life.
ABSTRACT
Objective:To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.Methods:A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms ( r=0.394, P<0.01), anxiety ( r=0.640, P<0.01), depression ( r=0.533, P<0.01) and metacognition ( r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212. Conclusion:Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.
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Objective:To explore the status quo of young patients′ perception of partner responsiveness and fear of disease progression after surgery of cervical cancer, and to analyze the correlation between the two to provide a basis for targeted intervention.Methods:From October 2018 to June 2020, a convenient sampling method was used to select 121 young patients after radical resection of cervical cancer who were treated in East Branch of Qingdao Municipal Hospital. It was investigated by the Perceived Partner Responsiveness Scale and the Fear of Progression Questionnaire-Short Form in cancer patients.Results:The total score of perceived partner responsiveness of young patients with cervical cancer after surgery was (41.30 ± 6.14) points, and the total score of fear of disease progression was (31.10 ± 6.58) points; perceived partner responsiveness was negatively correlated with fear of disease progression ( r=-0.72, P<0.05). Multiple linear regression analysis showed that work status and perceived partner responsiveness were the influencing factors of patients' fear of disease progression ( t=11.54, 18.40, all P<0.05). Conclusions:The perception of partner responsiveness in young patients with cervical cancer after surgery is closely related to the fear of disease progression. Perception of partner responsiveness can affect patients′ fear of disease progression; it can improve the patients′ perception of partner responsiveness to improve their fear of disease progression.
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Objective:To explore the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder (PTSD) in patients with acute myocardial infarction(AMI) after discharge, and to clarify main intervention direction of PTSD in patients with AMI.Methods:Patients with AMI who were discharged from Tangshan Gongren Hospital between 1 month and 1 year were selected from November 2019 to November 2020.The cardiac discomfort symptoms scale, fear of progress questionnaire(FoP-Q-SF) and post-traumatic stress disorder self-rating scale(PTSD-SS) were used to investigate cardiac discomfort symptoms, fear of disease progress level and post-traumatic stress disorder status.Spearman rank correlation analysis was used to analyze the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder by SPSS 24.0 software. The mediating effect of fear of disease progress was analyzed by AMOS 24.0 software.Results:The PTSD score was (32.78±12.38) of patients with AMI discharged from hospital for 1 month to 1 year and the incidence of PTSD was 12.3%.Spearman correlation test showed cardiac discomfort symptoms and fear of disease progress were positively correlated with PTSD( r=0.530, 0.723, both P<0.01) and cardiac discomfort symptoms was positively correlated with fear of disease progress( r=0.518, P<0.01). Mediating effect test showed that fear of disease progress was a complete mediator between cardiac discomfort symptoms and PTSD. Conclusion:Cardiac discomfort symptoms can affect PTSD through a complete mediator of fear of disease progress.