Relationship between uncertainty in illness and fear of progression among lung cancer patients: The chain mediation model.

IF 3.4 4区医学 Q1 PSYCHIATRY

World Journal of Psychiatry Pub Date : 2025-05-19 DOI:10.5498/wjp.v15.i5.104979

Yi-Ling Yang, Xue-Qing Zhang, Yong-Qiang Yang, Er-Mao Li, Bo Zhou, You-Wen Gong

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引用次数: 0

Abstract

Background: Uncertainty in illness (UI) and fear of progression (FoP) are significant psychological challenges for lung cancer patients. Coping styles and social support are critical mediators, influencing patients' ability to manage the emotional and psychological burden of UI and FoP. However, limited research has explored the chain mediation effect of these factors on the relationship between UI and FoP, particularly among Chinese lung cancer patients.

Aim: To investigate the association between UI and FoP among patients with lung cancer.

Methods: Convenience sampling was used to recruit inpatients diagnosed with lung cancer at a tertiary hospital in Changde City between November and December 2023. A total of 320 participants completed the Mishel Uncertainty in Illness Scale, Simplified Coping Style Questionnaire, Mandarin Chinese Version of the Medical Outcomes Study Social Support Survey, and Fear of Progression Questionnaire-Short Form. The chain mediation analysis was performed using the PROCESS macro to examine the relationships between the variables.

Results: The results revealed that UI had a significant direct effect on FoP (effect = 0.224, 95%CI: 0.136-0.408). Additionally, three indirect pathways were identified: (1) Social support (effect = 0.128, 95%CI: 0.045-0.153); (2) Coping style (effect = 0.115, 95%CI: 0.048-0.157); and (3) Chain mediators involving social support and coping style (effect = 0.072, 95%CI: 0.045-0.120). The total indirect effect of the three mediation paths is 31.5%. These results confirm that social support and coping style significantly mediate the relationship between UI and FoP.

Conclusion: Based on cross-sectional data and a chain mediation model, this study explored the mechanisms between UI, social support, coping style, and FOP. Patients with lung cancer have higher levels of FOP, and the results of this study revealed a correlation between these four factors. Social support and coping style partially mediated the effects of UI on FOP, and there was a chain-mediating effect between UI and FOP. Programs designed to strengthen social support networks should also incorporate training to develop adaptive coping strategies, ultimately reducing FOP and improving overall quality of life.

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肺癌患者疾病不确定性与进展恐惧的关系：链式中介模型

背景：疾病不确定性（UI）和进展恐惧（FoP）是肺癌患者面临的重要心理挑战。应对方式和社会支持是影响患者处理UI和FoP情绪和心理负担能力的重要中介因素。然而，这些因素对UI与FoP关系的连锁介导作用，尤其是在中国肺癌患者中，研究还比较有限。目的：探讨肺癌患者UI与FoP的关系。方法：采用方便抽样方法，抽取常德市某三级医院2023年11 - 12月肺癌住院患者。共有320名被试完成了米舍尔疾病不确定度量表、简易应对方式问卷、中文版医疗结果研究社会支持调查和进展恐惧问卷简表。使用PROCESS宏执行链中介分析，以检查变量之间的关系。结果：UI对FoP有显著的直接影响（效应= 0.224,95%CI: 0.136 ~ 0.408）。(1)社会支持（效应= 0.128,95%CI: 0.045-0.153）；(2)应对方式（效应= 0.115,95%CI: 0.048 ~ 0.157）；(3)社会支持和应对方式为连锁中介（效应值= 0.072,95%CI: 0.045 ~ 0.120）。三种中介路径的间接效应合计为31.5%。这些结果证实了社会支持和应对方式在UI和FoP之间具有显著的中介作用。结论：本研究基于横断面数据和链式中介模型，探讨了用户界面、社会支持、应对方式与FOP之间的关系机制。肺癌患者的FOP水平较高，本研究结果揭示了这四个因素之间的相关性。社会支持和应对方式在UI对FOP的影响中起部分中介作用，UI与FOP之间存在链式中介效应。旨在加强社会支持网络的项目还应纳入培训，以制定适应性应对策略，最终减少FOP，提高整体生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Psychiatry PSYCHIATRY-

自引率

6.50%

发文量

110

期刊介绍： The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.