Background@#
Lung cancer is associated with significant
psychological distress , including
fear of progression (FoP). Because
insomnia and
depression are highly prevalent and associated with FoP, we examined the
association between FoP,
insomnia , and
depression in
cancer patients . Furthermore, we tested the
mediation effect of
cancer -related dysfunctional
beliefs about
sleep (C-DBS) on this
association . @*
Methods @#We analyzed data collected from
patients with surgically resected
non-small cell lung cancer from a single-center randomized controlled study investigating digital
healthcare applications. Baseline demographic and clinical variables were collected. In addition, selfreported
questionnaires including the
Fear of Progression
Questionnaire -Short Form,
Patients Health Questionnaire -9 items (
PHQ-9 ),
Insomnia Severity Index, and C-DBS were administered. @*Results@#Among the 320 enrolled
patients with
lung cancer , a regression model showed that FoP was predicted by age (β = −0.13, P = 0.007),
PHQ-9 (β = 0.35, P < 0.001), and C-DBS (β = 0.28, P < 0.001).
Insomnia did not directly influence FoP, but C-DBS mediated the
association .
Depression directly influenced FoP, but C-DBS did not mediate this
association . @*Conclusion@#Among
patients with surgically resected
lung cancer , C-DBS mediated the effects of severity of
insomnia on FoP.
Depression directly influenced FoP, but C-DBS did not influence this
association . To reduce FoP among
patients with
lung cancer , C-DBS should be addressed in the
cognitive behavioral therapy module.