Influence Study Of Metacognitive Therapy On Reproductive Concerns In Young Adult Female Cancer Survivors

Objective:To investigate the current situation of reproductive concerns in young adult female cancer survivors(YAFCS),explore the the feasibility and preliminary effect of metacognitive therapy(MCT)on YAFCS.Methods:The first part of this study was a cross-sectional study.From October2020 to December 2021,convenient sampling was used to recruit YAFCS meeting the screening criteria in the hospital site and on social media for questionnaire survey.The questionnaire included self-designed sociodemographics data,Reproductive Concerns After Cancer Scale(RCAC)and Metacognition questionnaire(MCQ-30).The second part was a self-control study,in which a baseline survey was completed among participants who volunteered for feasibility study after further screening using RCAC on a cross-sectional basis.All participants received MCT for 10 online sessions,and the intervention lasted about4～6 weeks.After the intervention,RCAC,MCQ-30,the State-trait Anxiety Scale(STAI),and Functional Assessment of Cancer Therapy-Generic scale(FACT-G)were used to evaluate the feasibility and preliminary effect.Three months after the intervention,participants were followed up and re-evaluated for effectiveness.The independent sample t test,univariate ANOVA analysis,multivariate linear regression,univariate repeated measures ANOVA and Pearson analysis were used for statistical analysis on SPSS 26.0,and the test level was α=0.05.Results:(1)In cross-sectional study,the mean RCAC total score of YAFCS was 49.97±12.52.57.9% of participants reported high levels of reproductive concerns on at least one dimension.The highest level of concerns was child’s health and the lowest was partner disclosure.In multiple linear regression analysis,MCQ-30 total scores had the greatest impact on reproductive concerns in YAFCS(P<0.001).(2)In feasibility study,a total of 43 YAFCS were recruited,and 24 were eventually enrolled for MCT intervention.The feasibility analysis results of MCT showed that the average score of each item about the acceptability and practicability of intervention reported by participants was 3.9～4.6.Attendance rates for each course range from 87.5% to 100%.The intervention completion rate was 91.7%,and the retention rate was87.5% with 2 patients dropped out during the implementation and 1refused to visit during the follow-up.Intervention compliance of intervention courses was 83.8%,and none of the participants showed adverse reactions about MCT.In the preliminary effect analysis of MCT,results of univariate repeated measures ANOVA showed that there were statistically significant differences in the total score of RCAC and fertility potential,partner disclosure,child’s health,personal health,and being pregnancy between before intervention and after intervention,and between before intervention and 3 months after the intervention(P<0.001),there were no statistically significant differences in acceptance scores between before intervention and after intervention and after intervention(P>0.05);There were statistically significant differences in S-AI and T-AI among participants before intervention and after intervention,and between before intervention and 3 months after intervention(P<0.001);There were statistically significant differences between the total score of the MCQ-30 and the positive beliefs about worry,negative beliefs about uncontrollability and danger of worry,need for control,cognitive confidence,and cognitive self-consciousness between before intervention and after intervention,and between before intervention and 3 months after intervention(P<0.001);There were statistically significant differences between the total score of FACT-G and the PWB,EWB,and FWB of the participants before intervention and after intervention,and between before intervention and 3 months after intervention(P<0.001),there were no statistically significant differences in scores of SWB between before intervention,after intervention and 3months after intervention(P>0.05).Conclusion:(1)57.9% of YAFCS had high levels of reproductive concerns,with the highest level of concerns about their children’s health and the lowest level of concerns about their partner disclosure;(2)Reproductive concerns was common in YAFCS,and metacognitions was an important influencing factor of it.(3)MCT has good feasibility in the application of reproductive concerns on YAFCS,and can effectively improve reproductive concerns,and their anxiety symptoms,metacognitions and quality of life,indicating that it could be promoted and applied in this population in the future.