Associations among physical symptoms, fear of cancer recurrence, and emotional well-being among Chinese American breast cancer survivors: a path model
Abstract
Purpose Most existing studies on fear of cancer recurrence (FCR) are exploratory without theoretical underpinnings and have been conducted among non-Hispanic Whites. Based on theoretical models, we hypothesized that more physical symptoms (pain and fatigue) would be associated with higher FCR, which, in turn would be related to lower emotional well-being among Chinese American breast cancer survivors.Methods Participants were 77 Chinese American women who were diagnosed with breast cancer of stages 0-III. A cross-sectional path analysis was conducted with a bootstrapping method.Results The final model showed that indirect paths from pain interference to emotional well-being and from fatigue to emotional well-being via FCR were significant. That is, higher levels of pain interference and fatigue were associated with higher FCR, which was further related to lower emotional well-being.Conclusions To our best knowledge, this is the first theory-driven study that investigates FCR experiences among Chinese American breast cancer survivors. Our study might provide a more comprehensive understanding of FCR as it simultaneously shows predictors and a psychological consequence of FCR. Results need to be replicated in large, racially/ethnically diverse samples and longitudinal studies.
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Patients with more severe fatigue report a higher degree of fear of cancer recurrence.
“Researchers have found that patients with more severe fatigue report a higher degree of FCR (Cho et al., 2018), possibly due to heightened vigilance to physical symptoms, which are sometimes misinterpreted as signs of recurrence.”
From Acceptance and commitment therapy effectiveness for fear of cancer recurrence: A systematic review and meta-analysis. (2025) · cites this paper as Cho et al., 2018
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- Authors
- Cho, D., Chu, Q., & Lu, Q.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- University of Houston (US)
- Corresponding author
- Cho, Dalnim
- ORCID
- Venue
- Supportive Care in Cancer
- Published
- 2017-12-14
- Volume
- 26
- Issue
- 6
- Pages
- 1755-1761
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W2773961813
- Cited by
- 28
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 1 · 2022: 5 · 2021: 2 · 2020: 5 · 2019: 4 · 2018: 1
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Cancer Society (MRSGT-10-011-01-CPPB)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- fear of cancer recurrence, breast cancer survivors, Chinese American women, somatic symptoms, pain interference, fatigue, emotional well-being
- MeSH terms
- Cancer Survivors, Adult, Aged, Asian, Breast Neoplasms, Cross-Sectional Studies, Fear, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Quality of Life
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