European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2025
The role of intolerance of uncertainty in health anxiety in cancer patients: Exploring demographic and cancer-related variations.
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Poshtan M Mojtaba, Aflakseir Abdulaziz, Witthöft Michael, Cherry Mary Gemma, Rahimi Taghanaki Changiz, Ramzi Mani
Аннотация
PURPOSE: Health anxiety (HA) is a critical issue for cancer patients. This study investigates the role of intolerance of uncertainty (IU) in HA among a heterogeneous sample of cancer patients, comparing those with hematological malignancies and solid tumor cancers. It also explores the impact of demographic and cancer-related factors on HA.
METHODS: A total of 184 cancer patients participated in this study. Measurement model and structural model were assessed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the reliability, validity, direct and indirect effect, explanatory power, and predictive power of constructs in the model. Multigroup analyses and moderation effects of demographic and cancer-related variables were also examined.
RESULTS: IU significantly predicted HA, mediated by negative problem orientation (NPO) and positive beliefs about worry (PBW). females scored higher in HA, NPO, and cognitive avoidance (CA), while males scored higher in PBW. Solid tumor patients exhibited a stronger positive relationship between IU and HA than hematological malignancy patients. Age and marital status also affected the relationships between IU, NPO, and PBW. Patients without a history of chronic illness or COVID displayed stronger associations between IU and NPO.
CONCLUSION: IU is a key predictor of HA in cancer patients, with varying impacts across demographic and clinical groups. Tailored interventions addressing IU and related constructs help reduce HA, especially among patients with solid tumor cancers, female, married, older, lower educated, and newly diagnosed without former disease diagnosis. This study emphasizes the importance of considering patient heterogeneity in psychological interventions for HA.
METHODS: A total of 184 cancer patients participated in this study. Measurement model and structural model were assessed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the reliability, validity, direct and indirect effect, explanatory power, and predictive power of constructs in the model. Multigroup analyses and moderation effects of demographic and cancer-related variables were also examined.
RESULTS: IU significantly predicted HA, mediated by negative problem orientation (NPO) and positive beliefs about worry (PBW). females scored higher in HA, NPO, and cognitive avoidance (CA), while males scored higher in PBW. Solid tumor patients exhibited a stronger positive relationship between IU and HA than hematological malignancy patients. Age and marital status also affected the relationships between IU, NPO, and PBW. Patients without a history of chronic illness or COVID displayed stronger associations between IU and NPO.
CONCLUSION: IU is a key predictor of HA in cancer patients, with varying impacts across demographic and clinical groups. Tailored interventions addressing IU and related constructs help reduce HA, especially among patients with solid tumor cancers, female, married, older, lower educated, and newly diagnosed without former disease diagnosis. This study emphasizes the importance of considering patient heterogeneity in psychological interventions for HA.