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已发表论文
乳腺癌术后疾病恐惧患者心理功能障碍的影响因素及预测模型
Authors Fei YJ, Liu FH, Yao J , Ding XR, Tang JY, Ye X, Zhou TH, Xu HP
Received 9 June 2025
Accepted for publication 4 November 2025
Published 15 November 2025 Volume 2025:18 Pages 7499—7510
DOI https://doi.org/10.2147/JMDH.S545763
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Krzysztof Laudanski
Yu-Jie Fei,1,* Feng-He Liu,1,* Jia Yao,2 Xin-Ru Ding,1 Jing-Yi Tang,1 Xu Ye,1 Tian-Hao Zhou,1 Hai-Ping Xu1
1School of Nursing, Nanjing Medical University, Nanjing, 211166, People’s Republic of China; 2School of Public Health, Boston University, Boston, MA, 02118, USA
*These authors contributed equally to this work and shared first authorship
Correspondence: Hai-Ping Xu, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, People’s Republic of China, Email xhphappy9@126.com
Background: Fear of disease progression is a prevalent psychological challenge among breast cancer survivors, often leading to significant psychological dysfunction and serious sequelae, such as post-traumatic stress syndrome and impaired immunity. However, the factors influencing this dysfunction in the early postoperative period remain unclear. Therefore, this study aimed to identify the influencing factors and construct a risk-prediction model for psychological dysfunction in breast cancer patients with postoperative fear of disease.
Methods: Using convenience sampling, we selected 202 patients who underwent breast cancer surgery in a Class III Grade A hospital in Jiangsu Province, between January and August 2024. All patients completed a general information questionnaire (which collected data on tumor stage), disease-related scales, the Fear of Progression Questionnaire-Short Form, a breast cancer quality-of-life scale, the Posttraumatic Growth Inventory, and the Fear of Cancer Recurrence-Short Form.
Results: Of the 202 patients, 75 (37.1%) developed psychological dysfunction. Single-factor analyses revealed that factors such as tumor stage, education level, surgical method, fear of cancer recurrence, and quality of life (P < 0.05) were significantly related to psychological dysfunction. Logistic regression revealed education level, surgical method, fear of cancer recurrence, and quality of life as influencing factors for psychological dysfunction (P < 0.05). The Hosmer-Lemeshow goodness-of-fit test of the model showed a result of χ2 = 4.179 (P = 0.841). The area under the receiver operating characteristic curve was 0.860 (95% confidence interval: 0.807– 0.912). The Youden index was 0.617; the sensitivity and specificity of the optimal cut-off value were 0.853 and 0.764, respectively.
Conclusion: Breast cancer patients with postoperative fear of disease have a high risk of psychological dysfunction, which is influenced by factors such as surgical method, education level, postoperative quality of life, and fear of cancer recurrence.
Keywords: breast cancer, fear of disease progression, psychological dysfunction, influencing factor analysis, risk prediction model, nursing care
1School of Nursing, Nanjing Medical University, Nanjing, 211166, People’s Republic of China; 2School of Public Health, Boston University, Boston, MA, 02118, USA
*These authors contributed equally to this work and shared first authorship
Correspondence: Hai-Ping Xu, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, People’s Republic of China, Email xhphappy9@126.com
Background: Fear of disease progression is a prevalent psychological challenge among breast cancer survivors, often leading to significant psychological dysfunction and serious sequelae, such as post-traumatic stress syndrome and impaired immunity. However, the factors influencing this dysfunction in the early postoperative period remain unclear. Therefore, this study aimed to identify the influencing factors and construct a risk-prediction model for psychological dysfunction in breast cancer patients with postoperative fear of disease.
Methods: Using convenience sampling, we selected 202 patients who underwent breast cancer surgery in a Class III Grade A hospital in Jiangsu Province, between January and August 2024. All patients completed a general information questionnaire (which collected data on tumor stage), disease-related scales, the Fear of Progression Questionnaire-Short Form, a breast cancer quality-of-life scale, the Posttraumatic Growth Inventory, and the Fear of Cancer Recurrence-Short Form.
Results: Of the 202 patients, 75 (37.1%) developed psychological dysfunction. Single-factor analyses revealed that factors such as tumor stage, education level, surgical method, fear of cancer recurrence, and quality of life (P < 0.05) were significantly related to psychological dysfunction. Logistic regression revealed education level, surgical method, fear of cancer recurrence, and quality of life as influencing factors for psychological dysfunction (P < 0.05). The Hosmer-Lemeshow goodness-of-fit test of the model showed a result of χ2 = 4.179 (P = 0.841). The area under the receiver operating characteristic curve was 0.860 (95% confidence interval: 0.807– 0.912). The Youden index was 0.617; the sensitivity and specificity of the optimal cut-off value were 0.853 and 0.764, respectively.
Conclusion: Breast cancer patients with postoperative fear of disease have a high risk of psychological dysfunction, which is influenced by factors such as surgical method, education level, postoperative quality of life, and fear of cancer recurrence.
Keywords: breast cancer, fear of disease progression, psychological dysfunction, influencing factor analysis, risk prediction model, nursing care