Serial Multiple Mediation Model of Fear of Cancer Recurrence in Patients With Colorectal Cancer

Objective: The present study investigated the interrelationships among fatigue, depressive symptoms, resilience, and fear of cancer recurrence in patients with colorectal cancer. Method: Patients were recruited from the colorectal cancer surgical outpatient departments of two medical centers in northern Taiwan. A total of 416 patients with colorectal cancer at Stages 0–III were recruited. The Fatigue Symptom Inventory, Resilience Scale, Center for Epidemiological Studies Depression Scale, and Fear of Cancer Recurrence Inventory-Short Form were adopted. The generated serial multiple mediation model was examined using the Hayes PROCESS macro V4.3 in SPSS. Results: The patients had mild overall scores in fatigue, depressive symptoms, and fear of cancer recurrence but moderate scores in resilience. Notably, 46.6% of the patients had clinical-level scores in fear of cancer recurrence. Fear of cancer recurrence was negatively correlated with resilience and positively correlated with fatigue and depressive symptoms. Furthermore, resilience and depressive symptoms fully mediated the relationship between fatigue and fear of cancer recurrence. Conclusions: The findings of this study underscore the pivotal roles of resilience and depressive symptoms in the relationship between fatigue and fear of cancer recurrence. Therefore, health care providers are encouraged to prioritize early assessment and the management of depressive symptoms in patients with colorectal cancer and incorporate resilience-focused interventions into their care plans.