Poshtan M Mojtaba, Aflakseir Abdulaziz, Witthöft Michael, Cherry Mary Gemma, Rahimi Taghanaki Changiz, Ramzi Mani
Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran.
Department of Clinical Psychology, School of Education and Psychology, Shiraz University, Shiraz, Iran.
Eur J Oncol Nurs. 2025 Feb;74:102793. doi: 10.1016/j.ejon.2025.102793. Epub 2025 Jan 9.
Health anxiety (HA) is a critical issue for cancer patients. This study investigates the role of intolerance of uncertainty (IU) in HA among a heterogeneous sample of cancer patients, comparing those with hematological malignancies and solid tumor cancers. It also explores the impact of demographic and cancer-related factors on HA.
A total of 184 cancer patients participated in this study. Measurement model and structural model were assessed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the reliability, validity, direct and indirect effect, explanatory power, and predictive power of constructs in the model. Multigroup analyses and moderation effects of demographic and cancer-related variables were also examined.
IU significantly predicted HA, mediated by negative problem orientation (NPO) and positive beliefs about worry (PBW). females scored higher in HA, NPO, and cognitive avoidance (CA), while males scored higher in PBW. Solid tumor patients exhibited a stronger positive relationship between IU and HA than hematological malignancy patients. Age and marital status also affected the relationships between IU, NPO, and PBW. Patients without a history of chronic illness or COVID displayed stronger associations between IU and NPO.
IU is a key predictor of HA in cancer patients, with varying impacts across demographic and clinical groups. Tailored interventions addressing IU and related constructs help reduce HA, especially among patients with solid tumor cancers, female, married, older, lower educated, and newly diagnosed without former disease diagnosis. This study emphasizes the importance of considering patient heterogeneity in psychological interventions for HA.
健康焦虑（HA）是癌症患者面临的一个关键问题。本研究调查了不确定性不耐受（IU）在癌症患者异质性样本中的HA中的作用，比较了血液系统恶性肿瘤患者和实体肿瘤癌症患者。它还探讨了人口统计学和癌症相关因素对HA的影响。
共有184名癌症患者参与了本研究。使用偏最小二乘结构方程模型（PLS-SEM）评估测量模型和结构模型，以评估模型中各构念的可靠性、有效性、直接和间接效应、解释力和预测力。还检验了人口统计学和癌症相关变量的多组分析和调节效应。
IU显著预测HA，由消极问题取向（NPO）和对担忧的积极信念（PBW）介导。女性在HA、NPO和认知回避（CA）方面得分较高，而男性在PBW方面得分较高。实体肿瘤患者中IU与HA之间的正相关关系比血液系统恶性肿瘤患者更强。年龄和婚姻状况也影响IU、NPO和PBW之间的关系。无慢性病或新冠病史的患者中IU与NPO之间的关联更强。
IU是癌症患者HA的关键预测因素，在不同人口统计学和临床群体中的影响各异。针对IU及相关构念的量身定制干预措施有助于降低HA，尤其是在实体肿瘤癌症患者、女性、已婚、年龄较大、受教育程度较低且新诊断无前疾病诊断的患者中。本研究强调了在HA心理干预中考虑患者异质性的重要性。
