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中国癌症患者的复发恐惧:患病率、相关因素及网络分析

Fear of Recurrence in Chinese Cancer Patients: Prevalence, Correlates, and Network Analysis.

作者信息

Luo Xian, Li Wengao, Chen Yu, Sun Hengwen, Humphris Gerry, Liu Ting, Zhang Jingying, Yang Yuan, Zhang Bin

机构信息

Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China.

Department of Psychiatry, 999 Brain Hospital, Guangzhou, China.

出版信息

Front Psychiatry. 2022 Feb 7;13:803543. doi: 10.3389/fpsyt.2022.803543. eCollection 2022.

Abstract

BACKGROUND

Fear of cancer recurrence (FCR) is a significant issue for most cancer patients. Until now, a detailed investigation of the structure of FCR and the interaction among its constituent elements is lacking. This study aims to investigate the phenomenon of FCR by means of network analysis in Chinese cancer patients.

METHODS

This is a multi-center, cross-sectional study that included 996 cancer patients from southern China. All participants were assessed by the 7-item Chinese version Fear of Cancer Recurrence Scale (FCR-7). Multivariate logistic regression, and network analyses were conducted. Central symptoms (nodes) in the FCR network were identified.

RESULTS

Among the 996 patients, 543 (54.52%) reported moderate FCR, and 137 (13.76%) reported high FCR. Chemotherapy (OR = 2.954, = 0.016), and childhood severe illness experience (OR = 2.331, = 0.016) were positively associated with high FCR, while higher monthly income (OR = 0.403, = 0.046) was negative associated with high FCR. The node #FCR2 () was the most central node within the FCR network (Strength = 1.190), while node #FCR6 () was the least central node (Strength = 0.373). The edge FCR1-FCR2 (") was the thickest and most saturated edge in the network. After controlling for age and gender, an almost identical network was obtained with respect to edges magnitude and strength.

CONCLUSION

Fear of recurrence is a frequently reported issue among Chinese cancer patients. Patients with chemotherapy and childhood severe illness experience were more vulnerable and should be particularly monitored. Compared to behavioral component (i.e., body checking, overscreening and overtreatment) and cognitive component (i.e., intrusions), emotional component (i.e., worry/anxious) is more central to identify FCR and might be potential targets for further interventions.

摘要

背景

对癌症复发的恐惧(FCR)是大多数癌症患者面临的一个重要问题。到目前为止,缺乏对FCR结构及其构成要素之间相互作用的详细研究。本研究旨在通过网络分析对中国癌症患者的FCR现象进行调查。

方法

这是一项多中心横断面研究,纳入了来自中国南方的996名癌症患者。所有参与者均通过7项中文版癌症复发恐惧量表(FCR-7)进行评估。进行了多因素逻辑回归和网络分析。确定了FCR网络中的核心症状(节点)。

结果

在996名患者中,543名(54.52%)报告有中度FCR,137名(13.76%)报告有高度FCR。化疗(OR = 2.954,P = 0.016)和儿童期重症经历(OR = 2.331,P = 0.016)与高度FCR呈正相关,而月收入较高(OR = 0.403,P = 0.046)与高度FCR呈负相关。节点#FCR2(P = 0.000)是FCR网络中最核心的节点(强度 = 1.190),而节点#FCR6(P = 0.000)是最不核心的节点(强度 = 0.373)。边FCR1-FCR2(P = 0.000)是网络中最粗且最饱和的边。在控制年龄和性别后,就边的大小和强度而言,得到了一个几乎相同的网络。

结论

对复发的恐惧是中国癌症患者中经常报告的问题。有化疗和儿童期重症经历的患者更易出现,应特别加以监测。与行为成分(即身体检查、过度筛查和过度治疗)和认知成分(即侵入性思维)相比,情绪成分(即担忧/焦虑)在识别FCR方面更为核心,可能是进一步干预的潜在目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ce/8859333/9d70835cb906/fpsyt-13-803543-g0001.jpg

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