Fatigue and Fear of Cancer Recurrence in Colorectal Cancer Survivors: Mediating Effects of Illness Perception and Maladaptive Cognitive Emotion Regulation

BACKGROUND: Survivors living with colorectal cancer may have fear of cancer recurrence after surgery. Improving the disease perception and cognitive emotional coping style of patients with colorectal cancer may help to relieve fatigue symptoms and reduce the fear of cancer recurrence. OBJECTIVE: To explore the chained mediating effect of disease perception and nonadaptive cognitive emotion regulation between fatigue and the fear of cancer recurrence after colorectal cancer surgery. METHODS: Employing a cross-sectional design and recruiting participants via convenience sampling from 3 Chinese tertiary hospitals, this study collected data from 290 colorectal cancer survivors who were within 5 years postsurgery. The research utilized validated self-report measures to assess fatigue, illness perception, cognitive emotion regulation, and fear of progression. RESULTS: Participants were 63% male, with a mean age of 64.26 ± 11.79 years, and 81% within 6 months of cancer diagnosis. 55.86% exhibited psychological maladjustment from fear of cancer recurrence. Mediation analysis showed fatigue, illness perception, and maladaptive cognitive emotion regulation positively correlated with fear (P < .001). Fatigue had a 16.9% direct effect, while illness perception (52.2%) and maladaptive cognitive emotion regulation (12.3%) demonstrated independent mediating effects, with an 18.6% chain mediation effect. CONCLUSION: Fatigue influences the fear of cancer recurrence in colorectal cancer survivors through the chained mediating effect of disease perception and nonadaptive cognitive emotion regulation. IMPLICATION FOR PRACTICE: Targeted nursing and interdisciplinary interventions are needed to address fatigue, optimize disease perception, and reduce nonadaptive emotion regulation for better psychological adaptation in colorectal cancer survivors.