Possible Role of Cancer-Related Dysfunctional Beliefs About Sleep and Intolerance of Uncertainty on Cognitive-Behavioral Model of the COVID-Related Hypochondriasis Among Patients With Cancer
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Objective The aim of the present study was to evaluate the reliability and validity of the Korean version of the Obsession with COVID-19 Scale (OCS) and the feasibility of cognitive-behavioral models of COVID-related hypochondriasis among patients with cancer. Furthermore, we explored whether intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep could be incorporated into this model.Methods An online survey was conducted among patients who visited a cancer treatment center from March to June 2022. Responses were collected for questionnaires including the OCS, Coronavirus Reassurance-seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Cancer-related Dysfunctional Beliefs and Attitudes about Sleep-14 items (C-DBAS-14) scale, and Intolerance of Uncertainty-12 items (IUS-12) scale.Results A total of 154 patients with cancer were included. The OCS was a reliable and valid measure for coronavirus-related concerns among cancer patients, and it was significantly correlated with CRBS (p<0.01), SAVE-6 (p<0.01), IUS-12 (p<0.01), and C-DBAS-14 (p<0.01). Linear regression revealed that OCS was expected by CRBS (p<0.001), SAVE-6 (p=0.032), and IUS-12 (p=0.003). The mediation analysis revealed that dysfunctional beliefs about sleep did not directly affect coronavirus-related concerns. Instead, this relationship was fully mediated by anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty.Conclusion The cognitive-behavioral model of COVID-related hypochondriasis is feasible for patients with cancer. Anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty are positively correlated with coronavirus-related concerns. Additionally, dysfunctional beliefs about sleep may mediate this relationship.
Abstract
Objective The aim of the present study was to evaluate the reliability and validity of the Korean version of the Obsession with COVID-19 Scale (OCS) and the feasibility of cognitive-behavioral models of COVID-related hypochondriasis among patients with cancer. Furthermore, we explored whether intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep could be incorporated into this model.Methods An online survey was conducted among patients who visited a cancer treatment center from March to June 2022. Responses were collected for questionnaires including the OCS, Coronavirus Reassurance-seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Cancer-related Dysfunctional Beliefs and Attitudes about Sleep-14 items (C-DBAS-14) scale, and Intolerance of Uncertainty-12 items (IUS-12) scale.Results A total of 154 patients with cancer were included. The OCS was a reliable and valid measure for coronavirus-related concerns among cancer patients, and it was significantly correlated with CRBS (p<0.01), SAVE-6 (p<0.01), IUS-12 (p<0.01), and C-DBAS-14 (p<0.01). Linear regression revealed that OCS was expected by CRBS (p<0.001), SAVE-6 (p=0.032), and IUS-12 (p=0.003). The mediation analysis revealed that dysfunctional beliefs about sleep did not directly affect coronavirus-related concerns. Instead, this relationship was fully mediated by anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty.Conclusion The cognitive-behavioral model of COVID-related hypochondriasis is feasible for patients with cancer. Anxiety toward coronavirus, coronavirus reassurance-seeking behavior, and intolerance of uncertainty are positively correlated with coronavirus-related concerns. Additionally, dysfunctional beliefs about sleep may mediate this relationship.