Possible Role of Cancer-Related Dysfunctional Beliefs About Sleep and Intolerance of Uncertainty on Cognitive-Behavioral Model of the COVID-Related Hypochondriasis Among Patients With Cancer.

OBJECTIVE

The aim of the present study was to evaluate the reliability and validity of the Korean version of the Obsession with COVID-19 Scale (OCS) and the feasibility of cognitive-behavioral models of COVID-related hypochondriasis among patients with cancer. Furthermore, we explored whether intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep could be incorporated into this model.

METHODS

An online survey was conducted among patients who visited a cancer treatment center from March to June 2022. Responses were collected for questionnaires including the OCS, Coronavirus Reassurance-seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Cancer-related Dysfunctional Beliefs and Attitudes about Sleep-14 items (C-DBAS-14) scale, and Intolerance of Uncertainty-12 items (IUS-12) scale.

RESULTS

A total of 154 patients with cancer were included. The OCS was a reliable and valid measure for coronavirus-related concerns among cancer patients, and it was significantly correlated with CRBS (p<0.01), SAVE-6 (p<0.01), IUS-12 (p<0.01), and C-DBAS-14 (p<0.01). Linear regression revealed that OCS was expected by CRBS (p<0.001), SAVE-6 (p=0.032), and IUS-12 (p=0.003). The mediation analysis revealed that dysfunctional beliefs about sleep did not directly affect coronavirus-related concerns. Instead, this relationship was fully mediated by anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty.

CONCLUSION

The cognitive-behavioral model of COVID-related hypochondriasis is feasible for patients with cancer. Anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty are positively correlated with coronavirus-related concerns. Additionally, dysfunctional beliefs about sleep may mediate this relationship.