Objective  To explore the mediating effect of marital support between the correlation of fear of cancre recurrence (FCR) and the level of mindfulness in patients with gastric cancer.

Methods  Gastric cancer patients admitted to the department of gastroenterology in the Second Affiliated Hospital of Xuzhou Medical University from August 2020 to August 2022 were selected, and all patients underwent radical gastrectomy treatment. A general information survey, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Marital Support Questionnaire, and the Mindfulness Attention Awareness Scale (MAAS) were used to investigate the included study subjects. Spearman rank correlation analysis was used to explore the relationship between FCR, mindfulness level, and marital support. The Bootstrap method was used to verify the mediating effect of marital support on the FCR and mindfulness level in gastric cancer patients.

Results  A total of 120 patients were included. The total FoP-Q-SF score was (27.37±6.03), of which 22 patients had psychological dysfunction due to fear of disease progression. The total score of marital support was (56.81±18.03). The total MAAS score was (54.72±7.75). The results of correlation analysis showed that the FCR and its scores were negatively correlated with the scores of the patients' mindfulness level and total score and scores for each dimension of spousal support (P<0.05). Couple support was positively correlated with the score of mindfulness level (P<0.05). The mediation effect analysis showed couple support partially mediates the effect between FCR and level of mindfulness, with a mediation effect of 0.208, a direct effect of 0.448, a total effect of 0.656, and a mediation effect rate of 31.71%.

Conclusion  The FCR in gastric cancer patients is at an intermediate level, which can directly affect the level of mindfulness of patients, or indirectly affect the level of mindfulness through the mediation of marital support.

1.Shin J, Shin DW, Lee J, et al. Exploring socio-demographic, physical, psychological, and quality of life-related factors related with fear of cancer recurrence in stomach cancer survivors: a cross-sectional study[J]. BMC Cancer, 2022, 22(1): 414. DOI: 10.1186/s12885-022-09507-2.

2.Luigjes-Huizer YL, Tauber NM, Humphris G, et al. What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data Meta-analysis[J]. Psychooncology, 2022, 31(6): 879-892. DOI. 10.1002/pon.5921.

3.Prins JB, Deuning-Smit E, Custers JAE. Interventions addressing fear of cancer recurrence: challenges and future perspectives[J]. Curr Opin Oncol, 2022, 34(4): 279-284. DOI: 10.1097/CCO.0000000000000837.

4.Chirico A, Vizza D, Valente M, et al. Assessing the fear of recurrence using the Cancer Worry Scale in a sample of Italian breast cancer survivors[J]. Support Care Cancer, 2022, 30(3): 2829-2837. DOI: 10.1007/s00520-021-06718-4.  

5.Cheli S, Caligiani L, Martella F, et al. Mindfulness and metacognition in facing with fear of recurrence: a proof-of-concept study with breast-cancer women[J]. Psychooncology, 2019, 28(3): 600-606. DOI: 10.1002/pon.4984.  

6.Tungtong P, Ranchor AV, Schroevers MJ. Stress appraisal and emotion regulation mediate the association between mindfulness and affect in cancer patients: differential mechanisms for positive and negative affect[J]. Psychooncology, 2023, 32(10): 1548-1556. DOI: 10.1002/pon.6201.

7.泮燕,窦文娟,底玮. 乳腺癌术后癌症复发恐惧与夫妻支持和生活质量的关系[J]. 蚌埠医学院学报, 2022, 47(11): 1587-1590. [Pan Y, Dou WJ, Di W. Fear of cancer recurrence and its relationship with couple support and quality of life in breast cancer patients undergoing surgery[J]. Journal of Bengbu Medical College, 2022, 47(11): 1587-1590.] DOI: 10.13898/j.cnki.issn.1000-2200.2022.11.027.

8.Luz JK, Martini J, Clever K, et al. Psychometric properties of the fear of progression questionnaire for children (FoP-Q-SF/C)[J]. Klin Padiatr, 2020, 232(3): 136-142. DOI: 10.1055/a-1128-0471.

9.张姝玥,王芳,许燕,等. 夫妻支持问卷的编制及其信效度验证[J]. 中国心理卫生杂志, 2008, 22(12): 899-902, 912. [Zhang SY, Wang F, Xu Y, et al. Development and validation of spouse support inventory[J]. Chinese Mental Health Journal, 2008, 22(12): 899-902, 912.] DOI: 10.3321/j.issn:1000-6729.2008.12.009.

10.Ghawadra SF, Lim Abdullah K, Choo WY, et al. The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: a randomized control trial[J]. J Nurs Manag, 2020, 28(5): 1088-1097. DOI: 10.1111/jonm.13049.

11.马千惠,关玉霞,姜琳,等. 肺癌患者癌症复发恐惧现状调查及影响因素分析[J]. 北京医学, 2022, 44(12): 1075-1080. [Ma  QH, Guan YX, Jiang L, et al. Investigation of the current situation and influencing factors of cancer recurrence fear in patients with lung cancer[J]. Beijing Medical Journal, 2022, 44(12): 1075-1080.] DOI: 10.15932/j.0253-9713.2022.12.003.

12.胡鑫,卢惠娟,陆箴琦,等. 中青年癌症患者术后复发恐惧现况及影响因素的横断面调查[J]. 复旦学报(医学版), 2023, 50(1): 101-107. [Hu X, Lu HJ, Lu ZQ, et al. A cross-sectional survey of the current situation and influencing factors of postoperative recurrence fear in young and middle-aged cancer patients[J]. Fudan University Journal of Medical Sciences, 2023, 50(1): 101-107.] DOI: 10.3969/j.issn. 1672-8467.2023.01.014.

13.李露. 食管癌术后患者恐惧疾病进展与症状群的相关性研究[D]. 南昌: 南昌大学, 2019. [Li L. Study on the correlation between fear of disease progression and symptom groups in patients with esophageal cancer after operation[D]. Nanchang: Nanchang University, 2019.] https://cdmd.cnki.com.cn/article/cdmd-10403-1019198856.htm

14.夏叶,魏凤坤,刘玉棕,等. 夫妻自我表露在宫颈癌同步放化疗患者病耻感中的应用研究[J]. 赣南医学院学报, 2023, 43(1): 81-87. [Xia Y, Wei FK, Liu YZ, et al. Application of conjugal self-disclosure in stigma of patients with concurrent chemoradiotherapy for cervical cancer[J]. Journal of Gannan Medical University, 2023, 43(1): 81-87.] DOI: 10.3969/j.issn.1001-5779.2023.01.016.

15.张欢,程方方,庞增粉,等. 年轻女性乳腺癌患者和配偶支持应对与亲密关系的相关性研究[J]. 中华肿瘤防治杂志, 2021, 28(23): 1826-1830. [Zhang H, Cheng  FF, Pang ZF, et al. Relationship between support coping and intimate relationship in 180 young female breast cancer patients and their spouses[J]. Chinese Journal of Cancer Prevention and Treatment, 2021, 28(23): 1826-1830.] DOI: 10.16073/j.cnki.cjcpt.2021.23.11.

16.叶慧慧,葛莉娜,臧爽,等. 亲密关系在妇科癌症患者夫妻支持应对与生活质量间的中介效应研究[J]. 中国全科医学, 2022, 25(9): 1105-1112. [Ye HH, Ge LN, Zang S, et al. Study on the mediating effect of intimate relationship between dyadic coping and quality of life in gynecological cancer patients' couples[J]. Chinese General Practice, 2022, 25(9): 1105-1112.] DOI: 10.12114/j.issn. 1007-9572.2021.02.070.

17.徐威,王效影,许秀萍,等. 正念放松对新冠肺炎疫情期间心内科门诊患者睡眠质量和负性情绪的影响 [J]. 中国循证心血管医学杂志, 2020, 12(9): 1051-1054. [Xu  Wei, Wang XY, Xu XP, et al. Influence of mindfulness relaxation on sleep quality and negative emotion in out-patients of cardiology department during Corona Virus Disease 2019 epidemic period[J]. Chinese Journal of Evidence-Bases Cardiovascular Medicine, 2020, 12(9): 1051-1054.] DOI: 10.3969/j.issn.1674-4055.2020.09.07.

18.刘荣荣,郎红娟,刘志琛,等. 乳腺癌术后化疗患者正念水平现况调查及其影响因素分析[J]. 联勤军事医学, 2020, 34(12): 887-890. [Liu RR, Lang HJ, Liu ZC, et  al. Mindfulness level and its risk factors in patients with breast cancer undergoing postoperative chemotherapy[J]. Military Medicine of Joint Logistics, 2020, 34(12): 887-890.] DOI: 10.13730/j.issn.1009-2595.2020.12.014.

19.王羽. 胃癌患者术后癌因性疲乏与正念水平的相关性分析[J]. 河南医学研究, 2020, 29(35): 6566-6567. [Wang Y. Correlation analysis between cancer-related fatigue and mindfulness level in patients with gastric cancer[J]. Henan Medical Research, 2020, 29(35): 6566-6567.] DOI: 10.3969/j.issn.1004-437X.2020.35.012.

20.徐静,高屹. 配偶同步正念减压疗法对妇科恶性肿瘤化疗患者自我管理效能与情感的影响[J]. 护理实践与研究, 2021, 18(8): 1204-1206. [Xu J, Gao  Y. The effect of spouse synchronous mindfulness based stress reduction therapy on self-management efficacy and emotions of gynecological malignant tumor chemotherapy patients[J]. Nursing Practice and Research, 2021, 18(8): 1204-1206.] DOI: 10.3969/j.issn.1672-9676.2021.08.029.

21.范颖英,孙娟,张彩凤,等. 早期食管癌患者夫妻疾病感知婚姻调适社会支持与癌症复发恐惧的关系研究[J]. 临床心身疾病杂志, 2024, 30(3): 69-75. [Fan YY, Sun J, Zhang CF, et al. The relationship of couples'perception of illness,marital adjustment,and social support with the fear of cancer recurrence in early-stage esophageal cancer patients[J]. Journal of Clinical Psychosomatic Diseases, 2024, 30(3): 69-75.] DOI: 10.3969/j.issn.1672-187X.2024.03.015.