Factors Influencing Psychological Dysfunction and Prediction Model in Breast Cancer Patients with Postoperative Fear...

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.

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.

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.

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.