Department of Applied Psychology, New York University, New York City, USA.
Department of Oncology, Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Georgetown University, 2115 Wisconsin Ave. Suite 300 DC, N.W., 20007, Washington, USA.
Int J Behav Med. 2023 Oct;30(5):705-713. doi: 10.1007/s12529-022-10136-z. Epub 2022 Nov 4.
Extant literature on the relationship between cancer fatalism and psychological distress among Chinese American breast cancer survivors has been mixed, and few studies have examined potential mediators of this relationship. The current study examined how cancer fatalism is associated with psychological distress by investigating perceived personal control and fear of cancer recurrence as mediators, and acculturation as a moderator of these relationships.
A total of 220 Chinese American women diagnosed with stage 0-III breast cancer were recruited from California cancer registries and completed a telephone survey. The measurement of cancer fatalism examined one's view of health as a result of destiny. Validated measures of psychological distress (i.e., depressive and anxiety symptoms), fear of cancer recurrence, and perceived personal control were used. Acculturation was defined by English proficiency, preferred interview language, and number of years lived in the USA.
Higher cancer fatalism was directly associated with greater depressive and anxiety symptoms after controlling for covariates. This association was also mediated by higher fear of cancer recurrence, but not by perceived control. The mediation was not moderated by acculturation.
Our findings suggest that Chinese American breast cancer survivors' fatalistic beliefs may exacerbate fear of cancer recurrence, and, in turn, depressive and anxiety symptoms. Fear of recurrence was more salient than perceived control in their associations with psychological distress among Chinese American cancer survivors. Future intervention research may adopt cognitive approaches to alter Chinese survivors' fatalistic views of health outcomes to reduce their psychological distress.
现有的关于美籍华裔乳腺癌幸存者的癌症宿命论与心理困扰之间关系的文献存在差异，并且很少有研究探讨这种关系的潜在中介因素。本研究通过调查感知个人控制和对癌症复发的恐惧来检验癌症宿命论如何与心理困扰相关，将其作为中介因素，并将文化适应作为这些关系的调节因素。
从加利福尼亚癌症登记处招募了 220 名被诊断为 0-III 期乳腺癌的美籍华裔女性，并通过电话调查完成了问卷调查。癌症宿命论的测量检查了一个人对健康的看法是由命运决定的。使用了经过验证的心理困扰（即抑郁和焦虑症状）、对癌症复发的恐惧和感知个人控制的测量方法。文化适应由英语熟练程度、首选访谈语言和在美国居住的年数来定义。
在控制了协变量后，较高的癌症宿命论与较高的抑郁和焦虑症状直接相关。这种关联也通过更高的癌症复发恐惧来介导，但不是通过感知控制来介导。文化适应并没有调节这种中介作用。
我们的研究结果表明，美籍华裔乳腺癌幸存者的宿命论信念可能会加剧对癌症复发的恐惧，进而加剧抑郁和焦虑症状。在美籍华裔癌症幸存者中，与心理困扰相关的是对复发的恐惧，而不是感知控制。未来的干预研究可以采用认知方法来改变中国幸存者对健康结果的宿命论观点，以减轻他们的心理困扰。
