Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.
Department of Psychology, Bloomfield College, Bloomfield, NJ, USA.
Ann Behav Med. 2019 Mar 1;53(3):244-254. doi: 10.1093/abm/kay033.
Fear of cancer recurrence (FCR) is a top ongoing concern of breast cancer (BC) survivors and thus the focus of recent intervention development. The Self-Regulation Model of FCR (Lee-Jones C, Humphris G, Dixon R, Hatcher MB. Fear of cancer recurrence-a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology. 1997;6:95-105.) states that everyday cancer-related events trigger FCR, which, in turn, leads to specific behavioral responses, including checking the body for signs or symptoms of cancer. Links between triggering events, FCR, and checking behavior have not yet been studied in the context of daily life or at the within-person level.
The goal of this study was to examine whether FCR has a within-person link with daily checking behavior and whether FCR mediates the link between triggering events and checking behavior.
Seventy-two early-stage BC survivors completed daily diaries over a 21-day period approximately 5 months after BC surgery. FCR, checking behavior, and triggering events were assessed each evening.
Multilevel modeling results indicated that FCR predicted greater odds of same-day, but not next-day, checking behavior. We found that daily FCR significantly mediated the same-day effect of triggering events on checking behavior. These average within-person effects varied substantially between patients and were not explained by momentary negative affect.
Findings support the within-person relationship between triggering events, FCR, and checking behavior posited by guiding theory, and can inform FCR intervention development.
对癌症复发的恐惧（FCR）是乳腺癌（BC）幸存者目前最关注的问题，也是最近干预措施发展的重点。FCR 的自我调节模型（Lee-Jones C、Humphris G、Dixon R、Hatcher MB。对癌症复发的恐惧-解释恐惧加剧的文献综述和提出的认知公式。心理肿瘤学。1997;6:95-105.）指出，日常与癌症相关的事件会引发 FCR，进而导致特定的行为反应，包括检查身体是否有癌症迹象或症状。在日常生活中或个体内部水平上，尚未研究触发事件、FCR 和检查行为之间的联系。
本研究的目的是检验 FCR 是否与每日检查行为具有个体内联系，以及 FCR 是否在触发事件和检查行为之间起中介作用。
72 名早期 BC 幸存者在 BC 手术后大约 5 个月内完成了为期 21 天的每日日记。每天晚上评估 FCR、检查行为和触发事件。
多层次模型结果表明，FCR 预测当天而不是第二天检查行为的可能性更高。我们发现，每日 FCR 显著中介了触发事件对检查行为的当天影响。这些患者之间的平均个体内效应差异很大，无法用瞬间的负面情绪来解释。
研究结果支持指导理论提出的触发事件、FCR 和检查行为之间的个体内关系，并为 FCR 干预措施的发展提供信息。
