A Study On The Status And Influencing Factors Of Fear Of Cancer Recurrence In Patients With Primary Hepatocellular Carcinoma After TACE

ObjectiveTo understand the status of population sociology,fear of cancer recurrence,psychological resilience,social support and symptom occurrence in patients with primary hepatocellular carcinoma after TACE;to analyze the correlation of fear of cancer recurrence,psychological resilience,social support and symptom occurrence in patients with primary hepatocellular carcinoma after TACE,and the influencing factors of fear of cancer recurrence;to explore the mediating effect of psychological resilience between social support and fear of cancer recurrence in patients with primary hepatocellular carcinoma after TACE,in order to provide an empirical basis for reducing fear of cancer recurrence in patients with primary hepatocellular carcinoma after TACE.Method1.We selected 220 patients with primary hepatocellular carcinoma after TACE in the Grade A hospital by using convenient sampling method.From September 2018 to April 2019,they were surveyed by using General Status Questionnaire,Fear of Progression Questionnaire Short Form?Fo P-Q-SF?,Connor Davidson Resilience Scale Short Version?CD-RISC-10?,Social Support Rating Scale?SSRS?,M.D.Anderson Symptom Inventory-Part??MDASI-Part??and The Symptom Module Specific to Primary Liver Cancer?TSM-PLC?.2.The SPSS 20.0 statistical software was used for statistical analysis of the data,frequency and ratio were used for statistical description of counting data,and mean±standard deviation was used to describe the measurement data of normal distribution,the median?M?and the 25th and 75th percentages(P₂₅,P₇₅)were used to describe the measurement data of skewed distribution;independent sample t test and variance analysis were used to compare the level of fear of cancer recurrence of different general data patients with primary hepatocellular carcinoma after TACE;Pearson correlation analysis was used to examine the correlation between fear of cancer recurrence,psychological resilience,social support and Anderson symptoms of patients with primary hepatocellular carcinoma after TACE;Spearman correlation analysis was used to examine the correlation between fear of cancer recurrence and HCC specific symptoms of patients with primary hepatocellular carcinoma after TACE;multiple linear regression analysis was used to determine the risk factors of recurrence in patients with primary hepatocellular carcinoma after TACE;the mediating effect test program proposed by Wen Zhonglin was used to analyze the mediating effect,AMOS20.0 was used to construct the pathway model diagram of social support,psychological resilience and fear of cancer recurrence of patients with primary hepatocellular carcinoma after TACE,bootstrap method was used to verify the mediating effect.Bilateral statistical test performed with?=0.05 as the test standard,and P<0.05indicated that the difference was statistically significant.Result1.The study showed that the mean age of 220 patients with primary hepatocellular carcinoma after TACE was?58.15±9.89?years old,including 167 males?75.91%?and53 females?24.09%?,and 105 patients?47.73%?with a total score of?34 for fear of cancer recurrence.2.The total score of fear of cancer recurrence of patients with primary hepatocellular carcinoma after TACE was?30.83±7.94?,the physiological health dimension was?16.95±3.90?,and the social-family dimension was?13.88±4.62?.The total score of psychological resilience was?20.47±5.53?.The total score of social support was?36.70±6.59?,higher than the domestic norm,and the difference was statistically significant?P<0.05?,the subjective support dimension was?20.88±3.64?,the objective support dimension was?9.42±1.93?,and the utilization of social support dimension was?6.39±2.12?.The highest incidence of symptoms was pain?99.09%?,followed by dry mouth?97.73%?,poor appetite?83.18%?,distress?82.73%?and sleep disturbance?80.00%?.The highest severity of symptoms was pain?5.02±1.95?,followed by dry mouth?4.20±1.72?,distress?upset??2.89±2.00?,disturbed sleep?2.88±2.06?and poor appetite?2.76±1.91?.3.The difference in the score of fear of cancer recurrence in patients with primary hepatocellular carcinoma after TACE in general demograghic characteristics:there were statistically significant differences in gender,age,marital status,educational level,employment status,economic pressure brought by the disease,and the number of TACE?P<0.05?.4.The correlation analysis showed that the total score of fear of cancer recurrence was negatively correlated with the total score of psychological resilience?r=-0.644,P<0.01?,the total score of social support?r=-0.586,P<0.01?,the subjective support dimension?r=-0.460,P<0.01?,the objective support dimension?r=-0.504,P<0.01?,and the utilization of social support?r=-0.578,P<0.01?.It was positively correlated with Anderson symptoms?r=0.477,P<0.01?.5.Multiple linear regression results showed that the influencing factors of fear of cancer recurrence in patients with primary hepatocellular carcinoma after TACE include gender,age,degree of education,economic pressure brought by the disease,number of TACE treatments,employments status?on the job?,psychological resilience,social support and Anderson symptoms?F=31.205,Adjust R²=0.659,P<0.001?,which could explain 65.90%of the variation degree.6.The results of structural equation model showed that psychological resilience played a mediating effect between social support and fear of cancer recurrence in patients with primary hepatocellular carcinoma after TACE,and mediating effect accounted for 54.78%of the total effect.Conclusions1.FCR in patients with primary hepatocellular carcinoma after TACE was at a medium and high level,and medical stuff should evaluate the FCR in patients timely,and take corresponding intervention measures to maintain the mental health of patients.2.The lower level of FCR in patients with higher mental resilience and social support after TACE,the higher level of FCR in patients with more severe postoperative symptom burden.3.The influencing factors of FCR in patients with primary hepatocellular carcinoma after TACE were:gender,age,education level,economic pressure brought by the disease,TACE treatment times,employment status?on the job?,psychological resilience,social support and Anderson symptoms.4.Psychological resilience played an intermediary role between social support and FCR in patients with primary hepatocellular carcinoma after TACE,among which subjective support could indirectly affect FCR through psychological resilience,and the utilization of support could not only directly affect FCR,but also could indirectly affect FCR through psychological resilience.