Zhuang Jiaru, Wang Yuan, Wang Shan, Hu Renjing, Wu Yibo, Chen Ling
Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.
Department of Laboratory Medicine, Jiangnan University Medical Center, Wuxi, China.
Front Psychol. 2024 Jul 9;15:1400695. doi: 10.3389/fpsyg.2024.1400695. eCollection 2024.
Fear of disease progression (FoP) has been identified as one of the most prevalent unmet needs among breast cancer patients in recent years. The aim of this study was to examine FoP in patients with breast cancer and explore its associations with demographic and clinical characteristics, self-management efficacy, and family functioning. We also aimed to create a clinically-relevant prediction model based off of these factors (i.e., a "nomogram") to help identify patients' probability of experiencing high FoP.
A cross-sectional survey of breast cancer in patients at the Affiliated Hospital of Jiangnan University was conducted from June 2023 to February 2024. The study included the Demographic and Clinical Characteristics Questionnaire, the Fear of Disease Progression Scale (FoP-Q-SF), the Chinese Self-Management Efficacy Scale for Cancer Patients (C-SUPPH), and the Family Care Index Questionnaire (APGAR). Data analysis included descriptive statistics, independent-samples -test, one-way ANOVA, Pearson correlation analysis, and multiple regression analysis. A nomogram was constructed based on multiple regression results and the model performance was evaluated.
A total of 151 breast cancer patients were enrolled in the study. The mean (standard deviation) FoP score of the patients was 35.87 ± 9.24. The average score of C-SUPPH was 96.97 ± 17.29, and the average score of APGAR was 6.74 ± 2.98. Pearson correlation analysis showed that FoP was negatively correlated with self-management efficacy ( = -0.544, < 0.01) and family functioning ( = -0.730, < 0.01). Multiple regression analysis showed that age ( = -4.038), self-management efficacy ( = -0.085) and family functioning ( = -1.972) were significantly related to FoP, and together explained 36% of FoP variation ( = 0.360, = 20.50, < 0.001). The nomogram of these variables showed satisfactory prediction performance [the Bootstrap Correction Consistency Index (C-index) = 0.872]. According to previous studies, a C-index of >0.70 indicates that the model is acceptable.
We found that greater fear of cancer progression (FoP) was associated with younger age, lower self-management efficacy and poorer family functioning in breast cancer patients. Based on these variables, our exploratory prediction model should be further investigated in order to help identify breast cancer patients who may be at highest risk of experiencing high FoP.
对疾病进展的恐惧（FoP）已被确定为近年来乳腺癌患者中最普遍的未满足需求之一。本研究的目的是调查乳腺癌患者的疾病进展恐惧情况，并探讨其与人口统计学和临床特征、自我管理效能以及家庭功能的关联。我们还旨在基于这些因素创建一个具有临床相关性的预测模型（即“列线图”），以帮助识别患者经历高疾病进展恐惧的概率。
于2023年6月至2024年2月对江南大学附属医院的乳腺癌患者进行了横断面调查。该研究包括人口统计学和临床特征问卷、疾病进展恐惧量表（FoP-Q-SF）、中国癌症患者自我管理效能量表（C-SUPPH）以及家庭关怀指数问卷（APGAR）。数据分析包括描述性统计、独立样本t检验、单因素方差分析、Pearson相关性分析和多元回归分析。基于多元回归结果构建列线图，并对模型性能进行评估。
本研究共纳入151例乳腺癌患者。患者的疾病进展恐惧平均（标准差）得分为35.87±9.24。C-SUPPH的平均得分为96.97±17.29，APGAR的平均得分为6.74±2.98。Pearson相关性分析显示，疾病进展恐惧与自我管理效能（r = -0.544，P < 0.01）和家庭功能（r = -0.730，P < 0.01）呈负相关。多元回归分析显示，年龄（β = -4.038）、自我管理效能（β = -0.085）和家庭功能（β = -1.972）与疾病进展恐惧显著相关，共同解释了疾病进展恐惧变异的36%（R² = 0.360，F = 20.50，P < 0.001）。这些变量的列线图显示出令人满意的预测性能[自举校正一致性指数（C指数）= 0.872]。根据以往研究，C指数>0.70表明该模型可接受。
我们发现，乳腺癌患者中对癌症进展的恐惧程度越高，与年龄越小、自我管理效能越低以及家庭功能越差有关。基于这些变量，我们的探索性预测模型应进一步研究，以帮助识别可能处于高疾病进展恐惧风险最高的乳腺癌患者。
