| Research Purpose:In this study,through a longitudinal investigation of the level of fear of progression（FoP）in colorectal cancer patients at different time points,the influencing factors and the change trajectory of FoP were analyzed,to provide a basis for clinically taking more targeted interventions in different treatment stages and identifying colorectal cancer patients with persistently high levels of FoP as soon as possible.Research Methods:1.In this study,150 patients with colorectal cancer in a tertiary hospital in Zhejiang Province were selected by convenience sampling method.At four time points before surgery（T1）,the next day of the first chemotherapy（T2）,the next day of the third chemotherapy（T3）,and the next day of the sixth chemotherapy（T4）,the general information questionnaire,fear of disease were used.The patients were followed up with the Progress Simplified Scale（FoP-Q-SF）,the Perceived Social Support Scale（PSSS）,the Resilience Scale（CD-RISC）,and the Illness Uncertainty Scale（MUIS-A）.2.SPSS 25.0 software was used for statistical analysis,and mean ± standard deviation,frequency,and percentage were used for statistical description of data;independent samples t-test and analysis of variance（ANOVA）were used for univariate analysis of general data;Pearson’s analysis method was used to analyze the correlation of patients’ FoP-Q-SF score,PSSS score,CD-RISC score and MUIS-A score;The multiple linear regression analysis method was used to analyze the influencing factors of FoP of patients at four different time points;A latent class-length model（LCGM）was selected to explore the heterogeneous subgroups of the FoP change trajectories at four time points T1-T4 in colorectal cancer patients;X2 test and one-way ANOVA were used to identify factors affecting subgroup classification;repeated measures ANOVA was used to study the changing trend of FoP and its influencing factors,P<0.05 indicated statistical difference.Research Results:1.The FoP scores of colorectal cancer patients at four time points T1-T4 were（40.51±2.91）,（38.46±3.04）,（36.54±3.04）,and（34.46±3.44）respectively.The total FoP score,physical health dimension and The social and family dimension scores showed a downward trend;LCGM identified three subgroups of FoP changes in colorectal cancer patients during T1-T4: high stability group,high-low group and low stability group,accounting for 14%,58% and 28%.2.Repeated measures analysis of variance showed that the social support score of colorectal cancer patients gradually decreased during T1-T4 period:（62.25±3.93）,（60.70±5.71）,（57.34±5.27）,（56.24±4.20）points;the psychological resilience score gradually decreased Increased:（71.07±4.64）,（73.30±2.84）,（75.63±3.96）,（75.67±4.45）points;disease uncertainty score gradually decreased:（40.51±2.91）,（38.46±2.89）,（36.54 ±3.04）,（34.46±3.44）points.3.Multiple linear regression analysis showed that the influencing factors of FoP in patients with colorectal cancer at T1 time point were age,gender,monthly family income,psychological resilience,social support,and ambiguity（P<0.05）;at T2 time point were age,family monthly income,medical insurance type,pathological type,resilience,social support,vague and unpredictable（P<0.05）;T3 time point were age,medical insurance type,resilience,social support,lack of clarification and unpredictable（P<0.05）;T4 Time point were medical insurance type,resilience,social support,lack of clarification,and unpredictability（P<0.05）.4.Through the application of univariate analysis,it is found that the influencing factors of the heterogeneity of colorectal cancer patients include gender,age,family income,whether there is a spouse,type of medical insurance,psychological resilience,social support and the sense of uncertainty of the disease.Change track of FoP in patients with colorectal cancer（P<0.05）.Research Conclusion:1.From before surgery to after the sixth chemotherapy,the FoP level of colorectal cancer patients showed a downward trend with the passage of time;2.There are three heterogeneous groups in the FoP change trend of colorectal cancer patients,and they all show a downward trend;3.The influencing factors of FoP in colorectal cancer patients changed at each time point.Gender at time T1,age at time T1-T3,family monthly income at time T1-T2,type of medical insurance at time T2-T4,and pathological type at time T2 were the main influencing factors;psychological resilience,social support,The uncertainty of disease is the main influencing factor at T1-T4 time point.The main influencing factors of disease uncertainty are the fuzzy dimension at T1-T2 time point,the unpredictable dimension at T2-T4 time point,and the lack of clarification dimension at T3 time point;4.Factors such as gender,age,family income,whether there is a spouse,type of medical insurance,psychological resilience,social support and sense of disease uncertainty are related to the heterogeneity of the group trend of patients’ FoP changes. |
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