Department of Nursing, Zhongnan Hospital of Wuhan University, #169 East-Lake Road, Wuhan, 430071, China; Medical Department, Yangtze University, #1 Southern Ring Road, Jingzhou, 434023, China.
Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, #169 East-Lake Road, Wuhan, 430071, China.
Eur J Oncol Nurs. 2024 Jun;70:102600. doi: 10.1016/j.ejon.2024.102600. Epub 2024 Apr 30.
This longitudinal study sought to explore the impact of cortisol and hope levels on Fear of Cancer Recurrence (FCR) and Quality of Life (QOL) in a cohort of 552 breast cancer patients from three centers in Wuhan City.
A longitudinal study involving 552 breast cancer patients from three centers in Wuhan City utilized Chinese versions of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Herth Hope Index (HHI), and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale. Cortisol levels were measured thrice daily, and data was collected longitudinally three times. Data analysis was conducted using SPSS 26.0 and Mplus 8.3, employing a longitudinal path model constructed via the cross-lagged method.
The results showed there were significant correlations between FCR, cortisol levels, and QOL at different time points. A significant mediating model was found with outcomes related to hope levels. Specifically, FCR predicted a decrease in hope levels (β = -0.163, p < 0.001), which in turn led to a decrease in overall QOL (β = -0.078, p < 0.001), with a mediation effect accounting for 10.34%. Although there were correlations between FCR, cortisol levels, and QOL at different time points, further analysis revealed that cortisol levels did not exhibit a mediating effect between the two (95% confidence interval: -0.002 to 0.001).
This study demonstrated there were significant correlations among FCR, QOL, and hope levels. Considering hope as a crucial mediator between FCR and QOL, potential intervention strategies for optimizing the QOL of breast cancer patients are proposed.
本纵向研究旨在探讨皮质醇和希望水平对武汉市三家中心的 552 例乳腺癌患者的恐惧癌症复发（FCR）和生活质量（QOL）的影响。
一项涉及武汉市三家中心的 552 例乳腺癌患者的纵向研究，使用了中文版本的恐惧进展问卷-短表（FoP-Q-SF）、赫特希望指数（HHI）和癌症治疗功能评估-乳房（FACT-B）量表。皮质醇水平每天测量三次，数据纵向采集三次。使用 SPSS 26.0 和 Mplus 8.3 进行数据分析，采用交叉滞后方法构建纵向路径模型。
结果表明，FCR、皮质醇水平和 QOL 在不同时间点之间存在显著相关性。发现了一个与希望水平相关的显著中介模型。具体来说，FCR 预测希望水平下降（β=-0.163，p<0.001），这反过来又导致整体 QOL 下降（β=-0.078，p<0.001），中介效应占 10.34%。虽然 FCR、皮质醇水平和 QOL 在不同时间点之间存在相关性，但进一步分析表明，皮质醇水平在两者之间没有中介效应（95%置信区间：-0.002 至 0.001）。
本研究表明 FCR、QOL 和希望水平之间存在显著相关性。考虑到希望是 FCR 和 QOL 之间的关键中介因素，提出了优化乳腺癌患者 QOL 的潜在干预策略。
