Skip to main content
SpringerLink
Log in

Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The degree to which conscientiousness contributes to well-being in Chinese cancer survivors and the mechanisms through which conscientiousness is associated with well-being remain unclear. Based on Lent’s restorative well-being model [1], the current study tested a mediation model of the contribution of conscientiousness, positive reappraisal, and hopelessness to fear of cancer recurrence (FCR), and physical well-being in a sample of 238 Chinese cancer survivors.

Method

Participants completed self-report questionnaires. Path analysis was used to analyze the linear relationships between the variables.

Results

The empirical model supported the mediator roles of positive reappraisal and hopelessness. Specifically, the results indicated that conscientiousness was first associated with positive reappraisal, which in turn was associated with decreased hopelessness, resulting in decreased FCR and improved physical well-being. In addition, the results showed that conscientiousness was associated with decreased hopelessness, which was then associated with decreased FCR and greater physical well-being.

Conclusion

Conscientiousness confers benefits on FCR and physical well-being through the mechanisms of positive reappraisal and decreased hopelessness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Lent RW (2007) Restoring emotional well-being: a theoretical model. In: Feuerstein M (ed) Handbook of cancer survivorship. Springer, New York, pp. 231–248

    Chapter  Google Scholar 

  2. Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, Ozakinci G (2013) Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv 7:300–322

    Article  Google Scholar 

  3. Lee S, Chen L, Ma GX, Fang CY, Oh Y, Scully L (2013) Challenges and needs of Chinese and Korean American breast cancer survivors: in-depth interviews. N Am J Med Sci 6(1):1–8

    Google Scholar 

  4. Parker G, Gladstone G, Chee KT (2001) Depression in the planet’s largest ethnic group: the Chinese. Am J Psychiatr 158:857–864

    Article  CAS  Google Scholar 

  5. Lee-Jones C, Humphris G, Dixon R, Hatcher MB (1997) Fear of cancer recurrence—a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psycho-Oncology 6:95–105

    Article  CAS  Google Scholar 

  6. Waldrop DP, O'Connor TL, Trabold N (2011) “waiting for the other shoe to drop:” distress and coping during and after treatment for breast cancer. J Psychosoc Oncol 29:450–473

    PubMed  Google Scholar 

  7. Avis NE, Smith KW, McGraw S, Smith RG, Petronis VM, Carver CS (2005) Assessing quality of life in adult cancer survivors (QLACS). Qual Life Res 14:1007–1023

    Article  Google Scholar 

  8. Vickberg SM (2003) The concerns about recurrence scale (CARS): a systematic measure of women's fears about the possibility of breast cancer recurrence. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 25:16–24

    Article  Google Scholar 

  9. Denmark-Wahenfried W, Pinto BM, Gritz ER (2006) Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol 24:5125–5131

    Article  Google Scholar 

  10. van Weert E, Hoekstra-Weebers J, May A, Korstjens I, Ros W, van der Schans C (2008) The development of an evidence-based physical self-management rehabilitation programme for cancer survivors. Patient Educ Couns 71:169–190

    Article  Google Scholar 

  11. Hoffman M, Lent R, Raque-Bogdan T (2013) A social cognitive perspective on coping with cancer: theory, research, and intervention. Couns Psychol 41(2):240–267

    Article  Google Scholar 

  12. Foster C, Fenlon D (2011) Recovery and self-management support following primary cancer treatment. Br J Cancer 105:21–28

    Article  Google Scholar 

  13. John OP, Srivastava S (1999) The big five trait taxonomy: history, measurement, and theoretical perspectives. In: Pervin LA, John OP (eds) Handbook of personality: theory and research, 2nd edn. Guilford Press, New York, pp. 102–138

    Google Scholar 

  14. Friedman HS, Kern ML (2014) Personality, well-being, and health. Annu Rev Psychol 65:719–742

    Article  Google Scholar 

  15. Kotov R, Gamez W, Schmidt F, Watson D (2010) Linking “big” personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychol Bull 136:768–821

    Article  Google Scholar 

  16. Javaras KN, Schaefer SM, van Reekum CM, Lapate RC, Greischar LL, Bachhuber DR, Love GD, Ryff CD, Davidson RJ (2012) Conscientiousness predicts greater recovery from negative emotion. Emotion 12:875–881

    Article  Google Scholar 

  17. Bogg T, Roberts BW (2004) Conscientiousness and health-related behaviors: a meta-analysis of the leading behavioral contributors to mortality. Psychol Bull 130:887–919

    Article  Google Scholar 

  18. Bartley CE, Roesch SC (2011) Coping with daily stress: the role of conscientiousness. Personal Individ Differ 50:79–83

    Article  Google Scholar 

  19. Hill PL, Turiano NA, Hurd MD, Mroczek DK, Roberts BW (2011) Conscientiousness and longevity: an examination of possible mediators. Health Psychol 30:536–541

    Article  Google Scholar 

  20. Gross JJ (1998) The emerging field of emotion regulation: an integrative review. Rev Gen Psychol 2:271–299

    Article  Google Scholar 

  21. Skaali T, Fossa SD, Bremnes R, Dahl O, Haaland CF, Hauge ER, Klepp O, Oldenburg J, Wist E, Dahl AA (2009) Fear of recurrence in long-term testicular cancer survivors. Psycho-Oncology 18:580–588

    Article  Google Scholar 

  22. Mellon S, Kershaw TS, Northouse LL, Freeman-Gibb L (2007) A family-based model to predict fear of recurrence for cancer survivors and their caregivers. Psycho-Oncology 16:214–223

    Article  Google Scholar 

  23. Kvillemo P, Bränström R (2014) Coping with breast cancer: a meta-analysis. PLoS One 9:1–26

    Article  Google Scholar 

  24. Carver CS, Connor-Smith JK (2010) Personality and coping. Annu Rev Psychol 61:679–704

    Article  Google Scholar 

  25. Connor-Smith JK, Flachsbart C (2007) Relations between personality and coping: a meta-analysis. J Pers Soc Psychol 93:1080–1107

    Article  Google Scholar 

  26. Gartland N, O'Connor DB, Lawton R (2012) The effects of conscientiousness on the appraisals of daily stressors. Stress Health 28:80–86

    Article  Google Scholar 

  27. Wu Y, An Y, Wu X, Lin C (2014) Conscientiousness personality and posttraumatic growth: the mediating of coping style. Chinese Journal of Clinical Psychology 22:663–667

    Google Scholar 

  28. Alloy LB, Just N, Panzarella C (1997) Attributional style, daily life events, and hopelessness depression: subtype validation by prospective variability and specificity of symptoms. Cogn Ther Res 21:321–344

    Article  Google Scholar 

  29. Brothers BM, Andersen BL (2009) Hopelessness as a predictor of depressive symptoms for breast cancer patients coping with recurrence. Psycho-Oncology 18:267–275

    Article  Google Scholar 

  30. Seok J-H, Choi W-J, Lee YS, Park CS, Oh Y-J, Kim J-S, Chang H-S (2013) Relationship between negative mental adjustment to cancer and distress in thyroid cancer patients. Yonsei Med J 54:658–664

    Article  Google Scholar 

  31. Crist JV, Grunfeld EA (2013) Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-Oncology 22:978–986

    Article  Google Scholar 

  32. Watson M, Homewood J, Haviland J, Bliss JM (2005) Influence of psychological response on breast cancer survival: 10-year follow-up of a population-based cohort. Eur J Cancer 41:1710–1714

    Article  CAS  Google Scholar 

  33. Velting DW (1999) Personality and negative expectancies: trait structure of the Beck hopelessness scale. Personal Individ Differ 26:913–921

    Article  Google Scholar 

  34. Vollrath M, Torgersen S (2000) Personality types and coping. Personal Individ Differ 18:117–125

    Article  Google Scholar 

  35. O'Connor RC, O'Connor DB (2003) Predicting hopelessness and psychological distress: the role of perfectionism and coping. J Couns Psychol 50:362–372

    Article  Google Scholar 

  36. Abramson LY, Metalsky GI, Alloy LB (1989) Hopelessness depression: a theory-based subtype of depression. Psychol Rev 96:358–372

    Article  Google Scholar 

  37. Muthén LK, Muthén BO (2010) Mplus User's Guide, Sixth edn. Muthén & Muthén, Los Angeles, CA

    Google Scholar 

  38. Brislin RW (1970) Back-translation for cross-cultural research. J Cross-Cult Psychol 1:185–216

    Article  Google Scholar 

  39. Costa PT, McCrae RR (1992) Four ways five factors are basic. Personal Individ Differ 13(6):653–665

    Article  Google Scholar 

  40. Zhang L (2011) Psychosocial development and the big five personality traits among Chinese university students. Learn Individ Differ 23:163–167

    Article  CAS  Google Scholar 

  41. Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Gruen R (1986) The dynamics of a stressful encounter: cognitive appraisal, coping and encounter outcomes. J Pers Soc Psychol 50:992–1003

    Article  CAS  Google Scholar 

  42. Chesney MA, Neilands TB, Chambers DB, Taylor JM, Folkman S (2006) A validity and reliability study of the coping self-efficacy scale. Br J Health Psychol 11(3):421–437

    Article  Google Scholar 

  43. Watson M, Greer S, Young J, Inayat Q, Burgess C, Robertson B (1988) Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychol Med 18(1):203–209

    Article  CAS  Google Scholar 

  44. Akechi T, Fukue-Saeki M, Kugaya A, Okamura H, Nishiwaki Y, Yamawaki S, Uchitomi Y (2000) Psychometric properties of the Japanese version of the mental adjustment to cancer (MAC) scale. Psycho-Oncology 9:395–401

    Article  CAS  Google Scholar 

  45. Ferrell BR, Dow KH, Grant M (1995) Measurement of the quality of life in cancer survivors. Qual Life Res 4:523–531

    Article  CAS  Google Scholar 

  46. Jackson DL (2003) Revisiting sample size and number of parameter estimates: some support for the N:q hypothesis. Struct Equ Model 10:128–141

    Article  Google Scholar 

  47. MacCallum RC, Browne MW, Sugawara HM (1996) Power analysis and determination of sample size for covariance structure modeling. Psychol Methods 1(2):130–149

    Article  Google Scholar 

  48. Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 6:1–55

    Article  Google Scholar 

  49. Schumacker RE, Lomax RG (2004) A beginner’s guide to structural equation modeling, 2nd edn. Erlbaum, Mahwah, NJ

    Book  Google Scholar 

  50. Mallinckrodt B, Abraham WT, Wei M, Russell DW (2006) Advances in testing the statistical significance of mediation effects. J Couns Psychol 53:372–378

    Article  Google Scholar 

  51. Shrout PE, Bolger N (2002) Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods 7:422–445

    Article  Google Scholar 

  52. Lu Q, Uysal A, Teo I (2011) Needs satisfaction and catastrophizing: explaining the relationship among emotional ambivalence, pain, and depressive symptoms. J Health Psychol 16(5):819–827

    Article  Google Scholar 

  53. Penley JA, Tomaka J, Wiebe JS (2002) The association of coping to physical and psychological health outcomes: a meta-analytic review. J Behav Med 25:551–603

    Article  Google Scholar 

  54. Fardell JE, Thewes B, Turner J, Gilchrist J, Sharpe L, Smith AB, Girgis A, Butow P (2016) Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. J Cancer Surviv 10(4):663–673

    Article  Google Scholar 

  55. Park CL, Cho D, Blank TO, Wortmann JH (2013) Cognitive and emotional aspects of fear and recurrence: predictors and relations with adjustment in young to middle-aged cancer survivors. Psycho-Oncology 22:1630–1638

    Article  Google Scholar 

  56. Simard S, Savard J (2009) Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer 17:241–251

    Article  Google Scholar 

  57. Hwang WC, Myers HF, Chiu E, Mak E, Butner JE, Fujimoto K, Wood JJ, Miranda J (2015) Culturally adapted cognitive-behavioral therapy for Chinese Americans with depression: a randomized controlled trial. Psychiatric services (Washington, DC) 66:1035–1042

    Article  Google Scholar 

  58. Cheavens JS, Feldman DB, Gum A, Michael ST, Snyder CR (2006) Hope therapy in a community sample: a polit investigation. Soc Indic Res 77:61–78

    Article  Google Scholar 

  59. Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL (2014) Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol 82:1087–1100

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Kelly Yu-Hsin Liao

    Present address: Department of Counseling, Cleveland State University, Cleveland, OH, USA

  2. Nelson C.Y. Yeung

    Present address: The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Sha Tin, Hong Kong

Authors and Affiliations

  1. Department of Psychology, University of Houston, Houston, TX, 77204-5022, USA

    Kelly Yu-Hsin Liao, Nelson C.Y. Yeung, Celia C. Y. Wong, Krystal Warmoth & Qian Lu

Authors
  1. Kelly Yu-Hsin Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nelson C.Y. Yeung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Celia C. Y. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Krystal Warmoth
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qian Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qian Lu.

Ethics declarations

Ethical approval

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liao, K.YH., Yeung, N.C., Wong, C.C.Y. et al. Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness. Support Care Cancer 25, 1141–1149 (2017). https://doi.org/10.1007/s00520-016-3504-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3504-8

Keywords

Search

Navigation