癌症复发恐惧心理的管理模式探索及轨迹模型研究

癌症是世界范围内重要的公共卫生问题。癌症复发恐惧心理（FCR）是癌症患者生存期间的普遍现象，却是一个未得到关注和满足的需求。FCR的高发生率及潜在的负面影响使我们必须确定有效的管理策略。国内的FCR研究尚处于起步阶段，缺乏长程的追踪随访及干预试验。我们的前期研究显示近65%的国内新确诊癌症患者报告了高FCR，而化疗、童年重病经历、低收入、抑郁和焦虑是FCR升高的独立预测因素。基于此，本研究拟通过横断面调查，筛查癌症群体FCR水平，探讨FCR的影响因素，建立FCR预警模型，并将识别出的高FCR患者进行随机对照研究，分别提供8周在线的正念减压、认知行为和心理教育干预，在治疗前后评估患者的FCR、焦虑、抑郁、睡眠及生活质量，分析干预方式的疗效，再根据结果总结评价进而修订经典的Lee-Jones理论模型。以期构建筛查-干预-评价的FCR管理体系，实现早发现、早诊断、早治疗、早干预、早预防的目标。

Cancer is an important public health problem in the world.Fear of cancer recurrence (FCR) is a common phenomenon during the survival period of cancer patients,but it is also a demand that has not been paid attention to and met.The high incidence and potential negative impact of FCR make it necessary for us to determine effective management strategies.Domestic FCR research is still in its infancy,lack of long-term follow-up and intervention trials.Our previous studies showed that nearly 65% of newly diagnosed cancer patients in China reported high FCR,while chemotherapy,childhood severe illness experience,low income,depression and anxiety were independent predictors of increased FCR.Based on this,this study intends to screen the level of FCR in cancer population through a cross-sectional survey,explore the influencing factors of FCR, establish an early warning model of FCR,and conduct a randomized controlled study on the identified patients with high FCR,providing online mindfulness-based stress reduction,cognitive behavioral therapy and psychological education intervention for 8 weeks respectively.The patients' FCR, anxiety, depression, sleep and quality of life were evaluated before and after psychosocial intervention,and the curative effect of the intervention was analyzed.Then summarize and evaluate according to the results and then revise the classical Lee-Jones theoretical model.With a view to building a FCR management system of screening-intervention-evaluation,to achieve the goals of early detection,early diagnosis,early treatment, early intervention and early prevention.