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已发表论文
卵巢癌患者症状负担与死亡焦虑的关系：述情障碍的中介作用
Authors Liu X, Liang R, Ruan T, Yuan Y, Li Y, Lu J
Received 2 September 2025
Accepted for publication 23 January 2026
Published 4 February 2026 Volume 2026:19 564641
DOI https://doi.org/10.2147/JMDH.S564641
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jagdish Khubchandani
Xuyan Liu,1,* Renlong Liang,2,* Tingting Ruan,3 Ying Yuan,3 Yiwei Li,3 Jing Lu3
1Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, People’s Republic of China; 2Department of Neurology, Deyang Hospital Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Deyang, Sichuan, People’s Republic of China; 3Department of Gynaecology, Deyang People’s Hospital, Deyang, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yiwei Li, Department of Gynecology, Deyang People’s Hospital, No. 173, Section 1 of North Taishan Road, Jingyang District, Deyang City, Sichuan Province, 618000, People’s Republic of China, Email 11731191@qq.com
Purpose: This study aimed to reveal the relationship between death anxiety, symptom burden and alexithymia in ovarian cancer patients, and to explore the potential mediating role of alexithymia in the relationship between symptom burden and death anxiety.
Patients and Methods: 247 patients with ovarian cancer in five tertiary hospitals in Sichuan, China were investigated by convenient sampling method from March 2024 to March 2025. Participants completed demographic questionnaires, the MD Anderson Symptom Inventory, the Toronto Alexithymia Scale, and the Templer-Death Anxiety Scale. SPSS 27.0 software was used for Pearson correlation analysis and analysis of variance, and mediation analysis was conducted with Model 4 in the Process v4.2.
Results: Most patients were aged 45 years or older, had a senior high school education or below, were married, had medical insurance under the New Rural Cooperative Medical Scheme or Resident Basic Medical Insurance, and had a household income between 5000 and 10,000 yuan. The score of the Templer-Death Anxiety scale for ovarian cancer patients was (46.38 ± 6.92), which was at a high level. Statistically Significant differences were observed in death anxiety scores among patients of different ages, educational levels, tumor stages, disease duration, and marital status. Correlation analysis revealed significant correlations among symptom burden, alexithymia, and death anxiety. Symptom burden had a significant positive influence on alexithymia and death anxiety. Additionally, alexithymia had a significant positive impact on death anxiety. Mediation analysis revealed that alexithymia partially mediated the relationship between symptom burden and death anxiety.
Conclusion: We should focus on patients who are younger, unmarried or divorced/widowed, have lower educational attainment, are at a later stage of tumor progression, and have a shorter disease course. Symptom burden influences death anxiety in ovarian cancer patients by affecting alexithymia. Focusing solely on symptom burden without addressing patients’ alexithymia may not be sufficient to reduce their death anxiety.
Keywords: ovarian cancer, psychological factors, symptom assessment, emotional regulation
1Department of Nursing, Deyang People’s Hospital, Deyang, Sichuan, People’s Republic of China; 2Department of Neurology, Deyang Hospital Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Deyang, Sichuan, People’s Republic of China; 3Department of Gynaecology, Deyang People’s Hospital, Deyang, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yiwei Li, Department of Gynecology, Deyang People’s Hospital, No. 173, Section 1 of North Taishan Road, Jingyang District, Deyang City, Sichuan Province, 618000, People’s Republic of China, Email 11731191@qq.com
Purpose: This study aimed to reveal the relationship between death anxiety, symptom burden and alexithymia in ovarian cancer patients, and to explore the potential mediating role of alexithymia in the relationship between symptom burden and death anxiety.
Patients and Methods: 247 patients with ovarian cancer in five tertiary hospitals in Sichuan, China were investigated by convenient sampling method from March 2024 to March 2025. Participants completed demographic questionnaires, the MD Anderson Symptom Inventory, the Toronto Alexithymia Scale, and the Templer-Death Anxiety Scale. SPSS 27.0 software was used for Pearson correlation analysis and analysis of variance, and mediation analysis was conducted with Model 4 in the Process v4.2.
Results: Most patients were aged 45 years or older, had a senior high school education or below, were married, had medical insurance under the New Rural Cooperative Medical Scheme or Resident Basic Medical Insurance, and had a household income between 5000 and 10,000 yuan. The score of the Templer-Death Anxiety scale for ovarian cancer patients was (46.38 ± 6.92), which was at a high level. Statistically Significant differences were observed in death anxiety scores among patients of different ages, educational levels, tumor stages, disease duration, and marital status. Correlation analysis revealed significant correlations among symptom burden, alexithymia, and death anxiety. Symptom burden had a significant positive influence on alexithymia and death anxiety. Additionally, alexithymia had a significant positive impact on death anxiety. Mediation analysis revealed that alexithymia partially mediated the relationship between symptom burden and death anxiety.
Conclusion: We should focus on patients who are younger, unmarried or divorced/widowed, have lower educational attainment, are at a later stage of tumor progression, and have a shorter disease course. Symptom burden influences death anxiety in ovarian cancer patients by affecting alexithymia. Focusing solely on symptom burden without addressing patients’ alexithymia may not be sufficient to reduce their death anxiety.
Keywords: ovarian cancer, psychological factors, symptom assessment, emotional regulation