Relationship between Ambivalence over Emotional Expression and Cancer-related Fatigue with Adherence to Treatment in Cancer Patients


  • Atefeh Bashiri-Nejadian
    PhD in Health Psychology, Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, Iran, Islamic Republic of
  • Farzad Goli Professor, Faculty Instructor, Energy Medicine University, California, USA AND Head of Danesh-e Tandodrosti Institute, Isfahan AND Department of Education, Bioethics and Philosophy of Medicine, Iranian Academy of Medical Sciences, Tehran, Iran , Iran, Islamic Republic of
  • Mohammad Reza Sharbafchi Assistant Professor, Behavioral Sciences Research Center, Department of Psychiatry, Isfahan University of Medical Sciences, and Iranian Cancer Control Center (MACSA), Isfahan, , Iran, Islamic Republic of
February 29, 2024
March 2, 2024

Background: In addition to the body, cancer affects the mental health of patients and can be associated with significant cognitive-emotional and behavioral effects. Among the vital behavioral factors in cancer patients is adherence to treatment, which is essential due to the length of the treatment process. On the other hand, different styles of expressing emotions and fatigue related to this disease can impact adherence to treatment orders in patients. Therefore, the present research investigates the relationship of ambivalence over emotional expression (AEE) and cancer-related fatigue (CRF) with adherence to treatment in cancer patients.

Methods: The present study was a correlational research. The statistical population included all cancer patients with files in the Iranian Cancer Control Center (MACSA), Isfahan branch. From among them, 206 people (men and women) were selected through convenience sampling. The data collection tools used included the Ambivalence over the Expression of Emotion Questionnaire (AEQ; King and Emmons, 1990), Cancer Fatigue Scale (CFS; Okuyama et al., 2000), and General Adherence Scale (GAS;‎ Hays ‎et al., 1994). The collected data were analyzed using Pearson's correlation and stepwise regression statistical methods in SPSS software.

Results: As the results showed, there was a significant negative relationship between the variable of AEE and treatment adherence (r = -0.184; P < 0.01) and between the variable of CRF and treatment compliance (r = -0.173; P < 0.05). The variables of cancer fatigue and AEE predict a total of 4% of treatment adherence in cancer patients (R2 = 0.048).

Conclusion: The conflict in expressing or not expressing emotions the patients experience during the various stages of diagnosis and treatment, and the physical and psychological fatigue associated with the disease can significantly impact adherence to treatment in patients.

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