| Objective:1.To explore the psychological experience of fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.2.To investigate the current situation and analyze the influencing factors of fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.3.To explore the intervention effect of Mindfulness-based stress reduction on fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.Methods:1.Qualitative study of fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.Face-to-face and semi-structured interviews were conducted with breast cancer patients who met the inclusion criteria by using phenomenological research methods,and 7-step analysis method of Claizzi phenomenological data was used to sort out,code,summarize and analyze the collected interview data,so as to understand the psychological experience of fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.2.Analysis on the current situation and influencing factors of fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.The general information questionnaire,Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Brief Illness Perception Questionnaire(B-IPQ),Perceived Social Support Scale(PSSS)and Medical Coping Modes Questionnaire(MCMQ)were used to conduct a questionnaire survey on patients with breast cancer during postoperative chemotherapy.Frequency(f)and percentage(%)are used to describe counting data,and mean ± standard deviation(x±s)is used to describe measuring data.Independent sample t test and one-way ANOVA were used to test the difference of fear of cancer recurrence in general data.The correlation between the scores of FoP-Q-SF and the scores of B-IPQ,the scores of PSSS and the scores of MCMQ were tested by Pearson correlation analysis.The influencing factors of fear of cancer recurrence of breast cancer patients during postoperative chemotherapy were analyzed by multiple linear stepwise regression.3.Study on the intervention effect of Mindfulness-based stress reduction on the fear of cancer recurrence in patients with breast cancer during postoperative chemotherapy.104 patients were randomly divided into two groups:the intervention group and the waiting group.The general data,the scores of FoP-Q-SF and the scores of B-IPQ,the scores of PSSS and the scores of MCMQ of breast cancer patients in the waiting group and the intervention group were analyzed by chi square test,Fisher exact probability method and independent sample t.After the intervention,paired-sample t was used in order to explore the intervention effect of Mindfulness-based stress reduction on fear of cancer recurrence,we compared the scores of FoP-Q-SF,B-IPQ,PSSS and MCMQ before and after intervention between the two groups of breast cancer patients,and compared the scores of FoP-Q-SF,B-IPQ,PSSS and MCMQ after intervention with two independent samples.Results:1.In the qualitative study,12 interviewees were included.Four topics were extracted from the interview data,including suspicions and fears of recurrence,complicated inducements,adverse effects on individuals and families,various coping styles and different effects.2.In the cross-sectional study,186 valid questionnaires were collected,and the scores of FoP-Q-SF were 36.05±7.82,of which 65.1%were FoP-Q-SF?34.Independent sample t and one-way ANOVA showed that age,education level,family per capita monthly income and operation mode had influence on the level of recurrence fear(P<0.05).Pearson correlation analysis showed that the scores of B-IPQ of breast cancer patients were positively correlated with the scores of FoP-Q-SF and its dimensions(P<0.01),the scores of PSSS were negatively correlated with the scores of FoP-Q-SF and its dimensions(P<0.01),the scores of family support in PSSS were negatively correlated with the scores of FoP-Q-SF and its dimensions(P<0.01),the scores of friends' support and other support in PSSS were no significant correlated with the scores of FoP-Q-SF and its dimensions(P>0.05),the scores of face were negatively correlated with the scores of FoP-Q-SF and its dimensions in MCMQ(P<0.01),the scores of yield were positive correlated with the scores of FoP-Q-SF and its dimensions in MCMQ(P<0.01),the scores of avoidance were not correlated with the scores of FoP-Q-SF and its dimensions in MCMQ(P>0.05).Multiple regression showed that age,operation mode,family per capita monthly income,family support,illness perception and face were the main factors influencing the level of fear of cancer recurrence of breast cancer patients in the postoperative chemotherapy period.3.After the practice of Mindfulness-based stress reduction,the level of the fear of cancer recurrence in the intervention group was significantly improved after the intervention,the scores of FoP-Q-SF and its dimension,B-IPQ,avoidance and yield dimensions in MCMQ were significantly decreased(P<0.01),the scores of PSSS and its dimension,face dimension in MCMQ were significantly increased(P<0.01).After the intervention,the scores of B-IPQ,PSSS and yield in MCMQ were significantly increased(P<0.05)in the waiting group,while the remaining scores were not significantly changed.The results of the inter-group analysis showed that the scores of FoP-Q-SF and its dimensions,B-IPQ,avoidance and yield dimensions in MCMQ in the intervention group were significantly lower than those in the waiting group(P<0.05),while the scores of PSSS and its dimensions of family support and friends support,and face dimension in MCMQ were significantly higher than those in the waiting group(P<0.05).Conclusion:1.Fear of cancer recurrence not only leads to the increase of negative emotions and sleep disorders,but also causes the patients to worry too much about their family role in the future.The nurses should identify the behaviors and thoughts related to the recurrence fear in time,find the inducing factors,and guide the patients to deal with the recurrence fear effectively.2.Age,operation mode,family per capita monthly income,family support,illness perception and face are the important factors that affect the level of fear of cancer recurrence breast cancer patients in the postoperative chemotherapy period.3.Mindfulness-based stress reduction can significantly improve the level of patients' fear of recurrence,improve the level of patients' understanding of social support and reduce their negative cognition,and promote patients to actively face cancer. |
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