Department of Thoracic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Support Care Cancer. 2024 Oct 10;32(11):719. doi: 10.1007/s00520-024-08902-8.
Kinesiophobia refers to an irrational fear of physical activities or functional exercise due to the fear of pain or reinjury. Cancer patients who undergo esophagectomy are prone to developing kinesiophobia, which adversely affects their disease prognosis and quality of life. Somatic symptoms are closely related to kinesiophobia, but the mechanisms underlying this relationship remain unclear. Therefore, the current study aimed to explore the chain-mediation roles of intrusive rumination and avoidant coping in the relationship between somatic symptoms and kinesiophobia in cancer patients who underwent esophagectomy.
A cross-sectional study was conducted in China from February 2023 to December 2023. A total of 279 postesophagectomy cancer patients were evaluated using the Symptom Check List 90 (SCL-90), Event Related Rumination Inventory (ERRI), Medical Coping Modes Questionnaire (MCMQ), and Tampa Scale of Kinesiophobia (TSK-11).
Kinesiophobia was significantly positively correlated with somatic symptoms, intrusive rumination, and avoidant coping (p < 0.001). Somatic symptoms had a direct association with kinesiophobia (β = 0.280, 95% CI (0.200, 0.360), p < 0.001). Furthermore, our model showed that somatic symptoms had a significant indirect association with kinesiophobia through the separate mediating effects of intrusive rumination (β = 0.204, 95% CI (0.145, 0.267), p < 0.001) and avoidant coping (β = 0.049, 95% CI (0.019, 0.088), p < 0.001), as well as through the chain-mediated effects of intrusive rumination-avoidant coping (β = 0.026, 95% CI (0.012, 0.044), p < 0.001).
The findings of this study suggested that intrusive rumination and avoidant coping play separate and chain-mediated roles in the relationship between somatic symptoms and kinesiophobia in postesophagectomy cancer patients.
运动恐惧症是指由于害怕疼痛或再次受伤而对身体活动或功能锻炼产生不合理的恐惧。接受食管切除术的癌症患者容易出现运动恐惧症，这会对他们的疾病预后和生活质量产生不利影响。躯体症状与运动恐惧症密切相关，但两者之间的关系机制尚不清楚。因此，本研究旨在探讨侵入性反刍思维和回避应对在接受食管切除术的癌症患者躯体症状与运动恐惧症之间的链式中介作用。
本研究采用横断面研究，于 2023 年 2 月至 2023 年 12 月在中国进行。共纳入 279 例接受食管切除术的癌症患者，采用症状自评量表 90（SCL-90）、事件相关反刍思维问卷（ERRI）、医学应对方式问卷（MCMQ）和 Tampa 运动恐惧症量表（TSK-11）进行评估。
运动恐惧症与躯体症状、侵入性反刍思维和回避应对呈显著正相关（p<0.001）。躯体症状与运动恐惧症直接相关（β=0.280，95%CI（0.200，0.360），p<0.001）。此外，我们的模型显示，躯体症状通过侵入性反刍思维（β=0.204，95%CI（0.145，0.267），p<0.001）和回避应对（β=0.049，95%CI（0.019，0.088），p<0.001）的单独中介作用，以及通过侵入性反刍思维-回避应对的链式中介作用（β=0.026，95%CI（0.012，0.044），p<0.001）与运动恐惧症间接相关。
本研究结果表明，侵入性反刍思维和回避应对在接受食管切除术的癌症患者躯体症状与运动恐惧症之间具有独立的和链式中介作用。
