Séguin Leclair Caroline, Lebel Sophie, Westmaas J Lee
School of Psychology, University of Ottawa, Ottawa, ON, Canada.
Behavioral Research Center, American Cancer Society, Atlanta, GA, United States.
Front Psychol. 2021 Jun 9;12:647432. doi: 10.3389/fpsyg.2021.647432. eCollection 2021.
: Fear of cancer recurrence (FCR) adversely affects quality of life, but health behaviors such as physical activity (PA) and fruit and vegetable intake (FVI) may help alleviate FCR for some survivors. This cross-sectional study tested the common-sense model (CSM) of FCR by investigating associations between constructs from the CSM (perceived illness consequences, control over health, and timeline), and survivors' health behaviors, health self-efficacy, and FCR. : Using wave 3 data from the American Cancer Society Longitudinal Study of Cancer Survivorship-I, path analyses were conducted among mixed-cancer participants ( = 2,337) who were on average 8.8 mean years post-diagnosis. : A final good fitting model [ (5, = 2,337) = 38.12, < 0.001; SRMR = 0.02; CFI = 0.99; RMSEA = 0.05] indicated that perceiving fewer illness consequences, and greater control over one's health, were directly associated with higher PA ( = 0.15 and -0.24, < 0.01, respectively) and higher health self-efficacy ( = 0.24, -0.38, < 0.01, respectively). Timeline (i.e., perceiving cancer as chronic) was directly associated with lower health self-efficacy ( = -0.15, < 0.01) and higher FCR ( = 0.51, < 0.01). Both greater PA and FVI were directly associated with higher health self-efficacy ( = 0.10 and 0.11, < 0.01, respectively) which in turn showed a direct association with lower FCR ( = -0.15, < 0.01). : Increasing survivors' sense of control over health, decreasing perceived chronicity of the illness, and mitigating its consequences may increase their health behaviors and health self-efficacy, which in turn could decrease their FCR. Longitudinal and experimental studies are needed to confirm these findings.
对癌症复发的恐惧(FCR)会对生活质量产生不利影响,但诸如体育活动(PA)和果蔬摄入(FVI)等健康行为可能有助于减轻一些幸存者的FCR。这项横断面研究通过调查常识模型(CSM)中的构念(感知疾病后果、对健康的控制和时间线)与幸存者的健康行为、健康自我效能感和FCR之间的关联,对FCR的常识模型进行了测试。使用美国癌症协会癌症幸存者纵向研究-I的第3波数据,对平均诊断后8.8年的混合癌症参与者(n = 2337)进行了路径分析。最终的良好拟合模型[χ²(5,n = 2337)= 38.12,p < 0.001;SRMR = 0.02;CFI = 0.99;RMSEA = 0.05]表明,感知到的疾病后果越少,以及对自身健康的控制越强,与更高的PA(分别为β = 0.15和 -0.24,p < 0.01)和更高的健康自我效能感(分别为β = 0.24, -0.38,p < 0.01)直接相关。时间线(即将癌症视为慢性病)与较低的健康自我效能感(β = -0.15,p < 0.01)和较高的FCR(β = 0.51,p < 0.01)直接相关。更高的PA和FVI都与更高的健康自我效能感直接相关(分别为β = 0.10和0.11,p < 0.01),而这又与较低的FCR直接相关(β = -0.15,p < 0.01)。增强幸存者对健康的控制感、降低对疾病慢性程度的感知以及减轻其后果,可能会增加他们的健康行为和健康自我效能感,进而降低他们的FCR。需要纵向研究和实验研究来证实这些发现。