Psychology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
Department of Oncology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
Cancer Med. 2023 Sep;12(18):19215-19224. doi: 10.1002/cam4.6518. Epub 2023 Sep 14.
The impact of family and personal cancer history and emotional factors, such as depression and anxiety, on disease representation has received limited attention in studies investigating the development of cancer-related worry and risk perception within the context of genetic counseling. The current study endeavors to fill this gap by exploring the extent to which depression and anxiety influence cancer worry and risk perception, and the role of health care-related fear as potential mediator in this relationship.
A sample of 178 women who underwent their first genetic counseling for breast/ovarian cancer, 52% of whom had previous cancer diagnoses, completed questionnaires assessing sociodemographic and clinical information, emotional distress in terms of anxiety and depression, cancer-related worry, risk perception, and health care-related fears.
Results of mediation analyses showed that cancer-related worry and risk perception increased with rising levels of depression and anxiety, with health care-related fears acting as a mediator in the relationship of depression and anxiety with cancer worry and risk perception. Covariate analysis revealed that previous cancer diagnosis increases cancer-related worry but not risk perception, while the number of family members affected by cancer increases both outcomes.
These findings emphasize the need for a holistic approach in genetic counseling and have implications for the clinical practice.
在研究遗传咨询背景下癌症相关担忧和风险感知的发展时，家庭和个人癌症史以及抑郁和焦虑等情绪因素对疾病表现的影响在研究中受到的关注有限。本研究旨在通过探讨抑郁和焦虑对癌症担忧和风险感知的影响程度，以及医疗保健相关恐惧在这种关系中的潜在中介作用，来填补这一空白。
本研究纳入了 178 名接受首次乳腺癌/卵巢癌遗传咨询的女性，其中 52%的人曾被诊断患有癌症，她们完成了评估社会人口统计学和临床信息、焦虑和抑郁情绪困扰、癌症相关担忧、风险感知以及医疗保健相关恐惧的问卷。
中介分析结果表明，癌症相关担忧和风险感知随抑郁和焦虑水平的升高而增加，医疗保健相关恐惧在抑郁和焦虑与癌症担忧和风险感知的关系中起中介作用。协变量分析表明，先前的癌症诊断会增加癌症相关的担忧，但不会增加风险感知，而受癌症影响的家庭成员人数则会增加这两个结果。
这些发现强调了遗传咨询中需要采取整体方法，并对临床实践具有启示意义。
