关键词: 血液肿瘤, 恐惧疾病进展, 正念水平, 认知灵活性, 中介效应

Abstract: Objective: To explore the mediating effect of cognitive flexibility between the level of mindfulness and fear of disease progression in patients with hematological malignancies. Methods: Convenience sampling method was used and patients with hematologic malignancies in a grade A tertiary hospital were included from May 1, 2021 to August 31, 2022. General information questionnaire, cognitive flexibility questionnaire, five factor mindfulness scale, and fear of disease progression scale were used for investigation. Results: A total of 400 questionnaires were distributed and 373 were collected in the survey, with an effective response rate of 93.25%.The total score of fear of disease progression in patients with hematological malignancies was 35.03±5.50, the total score of cognitive flexibility was 69.98±13.15, and the total score of mindfulness was 112.76±13.15. Fear of disease progression was negatively correlated with cognitive flexibility (r=-0.534, P<0.001), negatively correlated with mindfulness (r=-0.602, P<0.001), and positively correlated with mindfulness and cognitive flexibility (r=0.442, P<0.001). Cognitive flexibility mediated the relationship between mindfulness and fear of disease progression, with a mediating effect size of -0.259, accounting for 41.48% of the total effect. Conclusion: Mindfulness not only directly affects the fear of disease progression in patients with hematological malignancies, but also has an impact on patients′ fear of disease progression through the mediating effect of cognitive flexibility. Caregivers should actively carry out intervention countermeasures based on the pathway that affects the progression of the fear disease, so as to reduce the degree of the progression of the fear disease and improve the mental health of patients.

Key words: Hematologic malignancies, Fear of disease progression, Mindfulness, Cognitive flexibility, Mediating effect