|
1
|
Liu M, Liu L, Lv Z, Zeng Q, Zhao J. Fear of cancer recurrence in patients with early-stage non-small cell lung cancer: A latent profile analysis. Asia Pac J Oncol Nurs 2025; 12:100663. [PMID: 40129486 PMCID: PMC11930574 DOI: 10.1016/j.apjon.2025.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 02/04/2025] [Indexed: 03/26/2025] Open
Abstract
Objective This study aimed to identify latent profiles of fear of cancer recurrence (FCR) among patients with early-stage non-small cell lung cancer (NSCLC) and examine the associated factors. Methods A cross-sectional survey was conducted with 677 patients with early-stage NSCLC who underwent surgical treatment at a tier-three cancer hospital in Beijing between January 2022 and August 2023. Data collection included demographic variables and assessments using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Herth Hope Index (HHI), and Social Support Rating Scale (SSRS). Latent profile analysis was employed to classify FCR levels and identify influencing factors. Results Three distinct FCR profiles emerged: "low FCR" (27.6%), "moderate FCR" (66.2%), and "high FCR" (6.2%). Independent risk factors for moderate FCR included individuals aged 36-60 years (odds ratio [OR] = 1.871, 95% confidence interval [CI] 1.208-2.899) and a household income below 5000 yuan (OR = 1.86, 95% CI 1.059-3.267). Protective factors for moderate FCR included lower levels of education (OR = 0.505, 95% CI 0.283-0.902), religious beliefs (OR = 0.355, 95% CI 0.152-0.833), and smoking (OR = 0.461, 95% CI 0.284-0.747). High FCR was strongly associated with being 36-60 years old, lower HHI scores (OR = 11.055, 95% CI 4.441-27.522), and poor social support (OR = 3.392, 95% CI 1.385-8.308). Conclusions FCR among patients with early-stage NSCLC can be categorized into distinct profiles, with specific demographic and psychosocial factors influencing severity. Tailored nursing interventions addressing varying FCR levels are critical to improving patient care and psychological well-being.
Collapse
Affiliation(s)
| | | | | | - Qingpeng Zeng
- National Cancer Center/National Clinical Research Center for Cancer (NCRCC)/Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jun Zhao
- National Cancer Center/National Clinical Research Center for Cancer (NCRCC)/Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
|
2
|
Acquati C, Cotter-Mena K, Sanchez C, LaMarca-Lyon A, Zhang A, Roth M. Informing Psychosocial Care for Young Couples Coping with Early-Onset Breast Cancer: A Cross-Sectional Examination of Unmet Service Needs and Their Association with Psychological Distress in the First Year Post-Diagnosis. J Adolesc Young Adult Oncol 2025; 14:227-237. [PMID: 39452509 DOI: 10.1089/jayao.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024] Open
Abstract
Objective: Young women diagnosed with breast cancer report greater psychological and physical morbidity than both older women and healthy peers. Similarly, young partners experience elevated cancer-related distress. Psychosocial oncology programs are not frequently attuned to the needs of young adult patients and may exclude their social networks. This marks a critical gap in psychosocial care delivery. The study investigated unmet service needs, psychological distress, and care preferences of young couples managing breast cancer in the first year post-diagnosis. Methods: Forty dyads (n = 80) of women aged 18-45 and their partners completed measures of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and a service use questionnaire adapted from previously published Adolescent and Young Adult (AYA) literature. The resulting 25 items assessed perceived care needs and service utilization across three domains: informational, emotional/supportive, and practical issues. Descriptive statistics, cross-tabulations, and bivariate correlations were computed. Actor and partner effects of unmet needs on mental health outcomes were investigated with generalized estimating equations (GEE). Results: Patients and partners were in their late thirties, mostly non-Hispanic White, married, highly educated, and employed. Approximately 60% of patients and 43%-66% of partners presented one or more unmet service needs, which correlated with greater distress. Unmet needs about information related to exercise, recurrence, nutrition, and symptom management were prevalent. Unmet supportive service needs of both patients and partners included age-appropriate programs, sexual health, and family counseling. Women reported practical needs for work/school accommodations, integrative care, financial issues and health coverage; while financial concerns, health insurance, and caregiving demands were priorities for partners. Conclusion: Young couples facing early-onset breast cancer experience large proportions of unmet service needs. These challenges were exacerbated by the lack of developmentally targeted psychosocial programs pertaining to informational, supportive, and practical care needs. Enhancing providers' understanding of the psychosocial issues affecting young couples' well-being, and the implementation of systematic procedures to detect and respond to their distress, is urgently needed.
Collapse
Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- Department of Clinical Sciences, Fertitta Family College of Medicine, University of Houston, Houston, Texas, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kristin Cotter-Mena
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- Datatude, Inc, Houston, Texas, USA
| | - Chelsea Sanchez
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Amy LaMarca-Lyon
- Department of Social Work, The UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Roth
- Division of Pediatrics, Department of Pediatrics Patient Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
|
3
|
Liu C, Chen L, Zheng J, Yu X, Gao H, Qiu L, Liu C. Latent Profiles of Fear of Cancer Recurrence in Breast Cancer Patients of Reproductive Age and Associations With Reproductive Concerns. J Adv Nurs 2025; 81:3013-3024. [PMID: 39278667 DOI: 10.1111/jan.16450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/18/2024]
Abstract
AIM To identify distinct profiles of fear of cancer recurrence (FCR) among breast cancer patients of reproductive age, investigate the relationship between these profiles and reproductive concerns and explore potential risk factors encompassing sociodemographic, clinical and reproductive characteristics. DESIGN A cross-sectional study was conducted from January 2022 to September 2022. METHODS A convenience sample of 210 reproductive-aged breast cancer patients completed a questionnaire that included a general information section, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Reproductive Concerns After Cancer Scale (RCAC). Latent profile analysis was conducted using the scores of the 12 items from the FoP-Q-SF as explicit variables, while univariate and multiple logistic regression analyses were employed for statistical analysis. RESULTS Three latent variables were identified: low FCR-stable group (27.6%), moderate FCR-uneasy group (17.2%) and high FCR-intense group (55.2%). This study found that FCR was predicted by age, education level, cancer stage, chemotherapy and fertility intention. Furthermore, patients with heightened reproductive concerns exhibited a higher likelihood of belonging to the high FCR-intense group. CONCLUSION These findings indicate that FCR varies among breast cancer patients of reproductive age and demonstrates individual differences. IMPLICATION Early identification of FCR patterns in patients is crucial for medical professionals, with particular attention given to those in the high-intensity FCR group. Tailored prevention and care strategies should be implemented based on the unique characteristics and influencing factors associated with different potential categories of FCR among patients of childbearing age with breast cancer. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Cuiting Liu
- School of Nursing, Putian University, Putian, China
| | | | | | - Xuefen Yu
- Department of Breast Surgery, Xiamen Women and Children's Hospital Affiliated to Xiamen University, Xiamen, China
| | - Huiting Gao
- Department of Breast Surgery, Xiamen Women and Children's Hospital Affiliated to Xiamen University, Xiamen, China
| | - Lijuan Qiu
- Department of Neurology, The First Hospital of Longyan City, Longyan, China
| | - Cuiping Liu
- Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Putian University, Putian, China
| |
Collapse
|
|
4
|
Bu X, Jiang L, Leung DYP. Family Involvement Interventions on Fear of Cancer Recurrence Management Among Women With Breast Cancer and Their Caregivers: A Systematic Review and Meta-Analysis. J Clin Nurs 2025. [PMID: 40369672 DOI: 10.1111/jocn.17790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 04/07/2025] [Accepted: 04/14/2025] [Indexed: 05/16/2025]
Abstract
BACKGROUND Family strengths can be used to help families adapt to hardship and strain. However, meta-analytic evidence of the effectiveness of family involvement interventions on fear of cancer recurrence (FCR) in women with breast cancer and their caregivers is lacking. OBJECTIVE To evaluate the effectiveness of family involvement interventions on FCR in women with breast cancer and their caregivers and to identify the characteristics of effective family involvement interventions. METHOD Ten electronic databases were searched from database inception to October 2023. The updated Cochrane risk-of-bias tool was used to assess the quality of the included randomised controlled trials (RCTs). Data analyses were executed with Revman 5.3 software, and subgroup analyses were performed on the basis of interventional dosage. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 checklist was employed to provide guidance. RESULTS Seven studies were included in the review, and six were included in the meta-analysis. The main contents included content related to the disclosure of disease-related feelings/worries/concerns/experiences, education/psychological support plus some disclosure and education/counselling based on disclosure content. The results of the meta-analysis showed that family involvement interventions have large short-term positive effects on relieving FCR in women with breast cancer. The pooled results of subgroup analysis demonstrated that compared with usual care, education/psychological support plus some disclosure is ineffective, and disclosure alone has a moderate-to-large effect size, whereas disclosure with education or counselling targeting the specific needs of participants has an extremely large effect size. Only one study focused on FCR in caregivers, with an unfavourable result. CONCLUSIONS Family involvement interventions, especially those using disclosure combined with education or counselling targeting their specific needs, have considerable short-term effects on women's FCR alleviation. However, the evidence in caregivers is insufficient. Only a few interventional studies targeting patients and caregivers exist. Further high-quality RCTs with follow-ups are encouraged. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Xiaofan Bu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Ling Jiang
- Department of Nursing, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| |
Collapse
|
|
5
|
Mao Y, Shi RX, Gao LM, Xu AY, Li JN, Wang B, Wu JY. Construction of a nomogram-based risk prediction model for depressive symptoms in middle-aged and young breast cancer patients. World J Clin Oncol 2025; 16:102208. [PMID: 40290700 PMCID: PMC12019283 DOI: 10.5306/wjco.v16.i4.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 01/04/2025] [Accepted: 02/14/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND Breast cancer (BC) is the second most common malignancy globally. Young and middle-aged patients face more pressures from diagnosis, treatment, costs, and psychological issues like self-image concerns, social barriers, and professional challenges. Compared to other age groups, they have higher recurrence rates, lower survival rates, and increased risk of depression. Research is lacking on factors influencing depressive symptoms and predictive models for this age group. AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model. METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province, China from November 2023 to April 2024 were included in the study. Participants were surveyed using a general information questionnaire, the patient health questionnaire depression scale, the visual analog scale for pain, the revised family support scale, and the long form of the international physical activity questionnaire. Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients, and a predictive model for depression risk was developed based on these findings. RESULTS Among the 360 middle-aged and young BC patients, the incidence rate of depressive symptoms was 38.61% (139/360). Multivariate analysis revealed that tumor grade, patient's monthly income, pain score, family support score, and physical activity score were factors influencing depression in this patient group (P < 0.05). The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852, with a maximum Youden index of 0.973, sensitivity of 86.80%, specificity of 89.50%, and a diagnostic odds ratio of 0.552. The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit (χ 2 = 0.360, P = 0.981). CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.
Collapse
Affiliation(s)
- Ye Mao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Rui-Xin Shi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Lei-Ming Gao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - An-Ying Xu
- School of Artificial Intelligence and Information Technology, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Jia-Ning Li
- Department of Nursing, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| | - Bei Wang
- Department of Nursing, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
- Department of Nursing, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| | - Jun-Yuan Wu
- Department of Critical Care Medicine, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| |
Collapse
|
|
6
|
Marmol-Perez A, Gracia-Marco L, Clavero-Jimeno A, Amaro-Gahete FJ, Ruiz JR, Carneiro-Barrera A. Effects of exercise-based interventions on health-related quality of life in adults after cancer: A systematic review and meta-analysis. Ann Phys Rehabil Med 2025; 68:101954. [PMID: 40252613 DOI: 10.1016/j.rehab.2025.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 01/20/2025] [Accepted: 02/02/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND Due to the lack of available knowledge in the current literature, this systematic review and meta-analysis was aimed to assess the effectiveness of exercise-based lifestyle interventions, including healthy diet and/or psychological well-being on mental, physical and global health-related quality of life (HRQoL) in adults after cancer treatment. METHODS MEDLINE (via PubMed) and Web of Science databases were searched for randomised controlled trials (RCTs) published until August 2024 evaluating exercise-based lifestyle interventions, including healthy diet and/or psychological well-being, which assessed mental, physical and global HRQoL. RESULTS Of 6193 screened studies, 32 RCTs met the criteria. The total sample comprised 5528 participants (3003 intervention and 2525 control). There was a small effect size in a pooled analysis that found exercise-based lifestyle interventions improve mental HRQoL (d 0.11, 95 % CI 0.05 to 0.18). These effects were greater in those studies that combined exercise with psychological well-being (d = 0.19, P = 0.004), and with moderate-to-high intensity aerobic exercise (moderate intensity; d = 0.11, P = 0.02, high intensity; d = 0.16, P = 0.02, aerobic exercise; d = 0.16, P = 0.26). CONCLUSIONS Exercise-based lifestyle interventions do not enhance physical nor global HRQoL, yet those combined with psychological well-being seem to improve mental HRQoL in individuals after cancer treatment. PROSPERO REGISTRATION NUMBER CRD42022369169.
Collapse
Affiliation(s)
- Andres Marmol-Perez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain. Menéndez Pelayo, 32, 18016, Granada, Spain; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678, USA.
| | - Luis Gracia-Marco
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain. Menéndez Pelayo, 32, 18016, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain. Av. de Madrid, 15, Beiro, 18012, Granada, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain. Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Antonio Clavero-Jimeno
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain. Menéndez Pelayo, 32, 18016, Granada, Spain
| | - Francisco J Amaro-Gahete
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain. Menéndez Pelayo, 32, 18016, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain. Av. de Madrid, 15, Beiro, 18012, Granada, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain. Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain. Menéndez Pelayo, 32, 18016, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain. Av. de Madrid, 15, Beiro, 18012, Granada, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain. Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Almudena Carneiro-Barrera
- Department of Psychology, Universidad Loyola Andalucía, 41007 Seville, Spain. Av. de las Universidades, 2, Dos Hermanas, Seville, Spain
| |
Collapse
|
|
7
|
Sahin TK, Sahin EA, Gungor HN, Guven DC, Barista I, Akin S. Fear of Cancer Recurrence and Associated Factors in Lymphoma Survivors and Their Family Caregivers: A Cross-Sectional Study. Cancer Med 2025; 14:e70561. [PMID: 40156226 PMCID: PMC11953567 DOI: 10.1002/cam4.70561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 11/27/2024] [Accepted: 12/20/2024] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a pervasive concern among lymphoma survivors and their family caregivers, influencing psychological and physical health. Given the substantial burden of FCR, identifying its predictors is crucial for targeted interventions that could enhance palliative care. We aimed to evaluate the prevalence of FCR in lymphoma survivors and their caregivers, as well as associated factors METHODS: A total of 118 patients with lymphoma, along with their family caregivers, were recruited from Hacettepe University Cancer Institute between March 2024 and May 2024. Psychological assessments were conducted using the Depression Anxiety Stress Scales (DASS-21), the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) and the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) RESULTS: High levels of FCR were experienced by 50.8% (n = 60) of lymphoma survivors and 57.6% (n = 68) of their caregivers. There was a positive correlation between the FCR of the survivors and caregivers (r = 0.349, p < 0.001). Poor overall quality of life (QoL) (aOR: 4.279, 95% CI: 1.738-10.531, p = 0.002), recent diagnosis (< 3 year) (aOR: 5.135, 95% CI: 1.852-14.238, p = 0.002), survivors' anxiety (aOR: 2.540, 95% CI: 1.014-6.363, p = 0.002) and caregivers' FCR (aOR: 2.970, 95% CI: 1.119-7.879, p = 0.029) were associated with high levels of FCR in lymphoma survivors. CONCLUSION We observed high FCR levels in over half the survivors with lymphoma and a higher FCR risk in patients with anxiety, poor QoL and caregiver FCR. These findings highlight the critical need for developing comprehensive care plans and interventions targeting FCR in patients with lymphoma.
Collapse
Affiliation(s)
- Taha Koray Sahin
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| | - Ezgi Aysu Sahin
- Department of Internal Medicine, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Hande Nur Gungor
- Department of Internal Medicine, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Deniz Can Guven
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
- Medical Oncology ClinicHealth Sciences University, Elazig City HospitalElazigTurkey
| | - Ibrahim Barista
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| | - Serkan Akin
- Department of Medical OncologyHacettepe University Cancer InstituteAnkaraTurkey
| |
Collapse
|
|
8
|
Liu W, Li W, Deng L, Luo X, Tan Y, Xiang J, Wu Y, Hu Y, Sun H, Yang Y. Characteristics and influencing factors of fear of cancer recurrence among family caregivers of breast cancer patients: a latent class analysis. BMC Nurs 2025; 24:352. [PMID: 40165266 PMCID: PMC11959734 DOI: 10.1186/s12912-025-02964-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 03/13/2025] [Indexed: 04/02/2025] Open
Abstract
BACKGROUND Family caregivers of breast cancer patients often experience significant psychological challenges, including depression, anxiety, and fear of cancer recurrence (FCR), yet these issues receive insufficient attention. This study aims to explore the heterogeneity of FCR among family caregivers and identify distinct subgroups based on their FCR levels. METHODS A cross-sectional survey was conducted with 866 family caregivers of breast cancer patients at two tertiary hospitals in Guangzhou, Guangdong Province. All participants completed the Fear of Cancer Recurrence Scale (FCR-7), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Scale (GAD-7) to assess their levels of FCR, depression, and anxiety. Latent class analysis (LCA) was used to identify subgroups of FCR, and multiple logistic regression analyses were performed to explore factors influencing FCR. RESULTS Three distinct subgroups of FCR were identified: low FCR group (16.17%), moderate FCR group (13.16%), and high FCR group (70.67%). Predictors of higher FCR included lower income, higher anxiety, and higher depression levels. CONCLUSIONS Family caregivers of breast cancer patients exhibit varying levels of FCR, with significant predictors being income, anxiety, and depression. Targeted interventions (e.g., psychoeducation, stress management, mindfulness exercises, and cognitive-behavioral therapy) that address these factors may help improve the mental health and well-being of family caregivers.
Collapse
Affiliation(s)
- Wenting Liu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, General Hospital of Southern Theatre Command, Guangzhou, China
| | - Lili Deng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yibing Tan
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiagen Xiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanan Hu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510000, China.
| |
Collapse
|
|
9
|
Wu J, Lan X, Liao Z, Chen J, Wu Y, Hu R. Comparison of the sense of spousal support, anxiety, depression and their relationship to fear of cancer recurrence between lymphoma patients and their spouses: A cross-sectional study in China. J Cancer Surviv 2025; 19:1-11. [PMID: 37610477 DOI: 10.1007/s11764-023-01443-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/29/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To investigate the level of fear of cancer recurrence (FCR) in spouses of patients with lymphoma and its relationship with patients' FCR, as well as the correlations between FCR, sense of spousal support (SSS), anxiety, and depression in the couples. METHODS A cross-sectional study of 233 couples where one partner had lymphoma was conducted from May 2021 to February 2022. Participants provided demographic information and completed the Spouse Support Inventory and Hospital Anxiety and Depression Scale. The Fear of Progression Questionnaire (for patients) and Fear of Progression Questionnaire for Partners (for spouses) were used to measure FCR. Descriptive analyses, t-tests, variance analysis, Spearman's correlation analysis, and multiple linear regression analysis was performed. RESULTS The prevalence of FCR, anxiety, and depression in patients was 37.7%, 68.7%, and 83.3%, respectively. The prevalence of FCR, anxiety, and depression in spouses was 56.2%, 78.1%, and 81.1%, respectively. Spouses' FCR scores were higher than those of patients, whereas patients' SSS and anxiety scores were higher than those of their spouses. Multiple linear regression analysis showed that patients' anxiety and SSS, as well as spouses' FCR were significantly associated with patients' FCR. Variables significantly associated with higher FCR among spouses were anxiety, per capita monthly household income, and patients' FCR. CONCLUSIONS Patients with lymphoma and their spouses have a certain degree of FCR, anxiety, and depression. FCR levels in spouses are higher than in patients. IMPLICATIONS FOR CANCER SURVIVORS Psychological support interventions for couples may be effective in reducing FCR and facilitating family adaptation to cancer.
Collapse
Affiliation(s)
- Junjun Wu
- The School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, 350108, China
| | - Xiaoyan Lan
- The School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, 350108, China
| | - Zhenling Liao
- The School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, 350108, China
| | - Jingyi Chen
- The School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, 350108, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, 350108, China.
| |
Collapse
|
|
10
|
Manne SL, Hudson SV, Preacher KJ, Imanguli M, Pesanelli M, Frederick S, Singh N, Schaefer A, Van Cleave JH. Prevalence and correlates of fear of recurrence among oral and oropharyngeal cancer survivors. J Cancer Surviv 2025; 19:66-77. [PMID: 37584880 PMCID: PMC10921339 DOI: 10.1007/s11764-023-01449-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Fear of recurrence (FoR) is a prevalent and difficult experience among cancer patients. Most research has focused on FoR among breast cancer patients, with less attention paid to characterizing levels and correlates of FoR among oral and oropharyngeal cancer survivors. The purpose was to characterize FoR with a measure assessing both global fears and the nature of specific worries as well as evaluate the role of sociodemographic and clinical factors, survivorship care transition practices, lifestyle factors, and depressive symptoms in FoR. METHODS Three hundred eighty-nine oral and oropharyngeal survivors recruited from two cancer registries completed a survey assessing demographics, cancer treatment, symptoms, alcohol and tobacco use, survivorship care practices, depression, and FoR. RESULTS Forty percent reported elevated global FoR, with similar percentages for death (46%) and health worries (40.3%). Younger, female survivors and survivors experiencing more physical and depressive symptoms reported more global fears and specific fears about the impact of recurrence on roles, health, and identity, and fears about death. Depression accounted for a large percent of the variance. Lower income was associated with more role and identity/sexuality worries, and financial hardship was associated with more role worries. CONCLUSIONS FoR is a relatively common experience for oral and oropharyngeal cancer survivors. Many of its correlates are modifiable factors that could be addressed with multifocal, tailored survivorship care interventions. IMPLICATIONS FOR CANCER SURVIVORS Assessing and addressing depressive symptoms, financial concerns, expected physical symptoms in the first several years of survivorship may impact FoR among oral and oropharyngeal cancer survivors.
Collapse
Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA.
| | - Shawna V Hudson
- Institute for Health, Health Care Policy and Aging Research, Robert Wood Johnson Medical School, 112 Paterson St, New Brunswick, NJ, 08901, USA
| | - Kristopher J Preacher
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Matin Imanguli
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
- Department of Otolaryngology-Head and Neck Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Morgan Pesanelli
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Sara Frederick
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Neetu Singh
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Alexis Schaefer
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Janet H Van Cleave
- NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY, 10010, USA
| |
Collapse
|
|
11
|
Alkhaifi M, Zhang E, Peera M, Jerzak K, Czarnota G, Eisen A, Roberts A, Carmona-Gonzalez CA, Pezo R, Gandhi S. Risk Factors for Treatment Toxicity and High Side Effect Burden Among Breast Cancer Survivors: A Retrospective Chart Review. Cancers (Basel) 2025; 17:328. [PMID: 39858109 PMCID: PMC11764302 DOI: 10.3390/cancers17020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Revised: 12/16/2024] [Accepted: 12/17/2024] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND/OBJECTIVES This study describes the sequelae, side effects, and toxicities experienced by Canadian breast cancer survivors at a breast cancer survivorship clinic at a tertiary academic cancer centre and identifies potential risk factors which may be associated with increased side effect burden. METHODS A retrospective chart review was performed of adult patients treated at the Sunnybrook Breast Cancer Survivorship Clinic from 6 July 2022, to 30 September 2023 (n = 435). RESULTS Most patients (72.6%) reported at least one side effect impacting their quality of life, and a smaller majority (55.4%) reported two or more side effects. The most common symptoms experienced were anxiety (29.4%), chronic pain (23.9%), hot flashes (21.4%), and fear of recurrence (19.8%). Older age was strongly correlated with a lower likelihood of experiencing greater side effect burden (p < 0.01). Patients who underwent chemotherapy were significantly more likely to experience higher side effect burden than patients who did not. Current smokers were more likely than nonsmokers or past smokers to have a higher burden, for both physical (p < 0.01) and psychological side effects (p < 0.01). The multivariate analysis demonstrated that younger age was strongly associated with greater side effect burden, higher likelihood of psychological and physical symptoms, and greater likelihood of requiring close follow-up. CONCLUSIONS The results highlight the need for survivorship resources tailored to survivors under the age of 55 and the importance of referring smokers to smoking cessation programs. Additional research is required to explore the significant reluctance among patients regarding discharge. Future studies should examine the acute needs of younger breast cancer survivors and investigate the impact of smoking and treatment modalities on the side effect burden.
Collapse
Affiliation(s)
- Muna Alkhaifi
- Department of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada; (E.Z.); (K.J.); (A.E.); (S.G.)
| | - Elwyn Zhang
- Department of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada; (E.Z.); (K.J.); (A.E.); (S.G.)
| | - Malika Peera
- Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Katarzyna Jerzak
- Department of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada; (E.Z.); (K.J.); (A.E.); (S.G.)
| | - Gregory Czarnota
- Department of Radiation Oncology Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Andrea Eisen
- Department of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada; (E.Z.); (K.J.); (A.E.); (S.G.)
| | - Amanda Roberts
- Department of Surgical Oncology Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Carlos Amir Carmona-Gonzalez
- Division of Medical Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
| | - Rosanna Pezo
- Department of Biological Sciences, Odette Cancer Research Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada;
| | - Sonal Gandhi
- Department of Medical Oncology & Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada; (E.Z.); (K.J.); (A.E.); (S.G.)
| |
Collapse
|
|
12
|
Ibrahim H, Ismail AA, Rahim NA, Iffland B, Neuner F. Childhood cancer and parental mental health: role of disease severity, socioeconomic status, and social dynamics. BMC Psychiatry 2025; 25:42. [PMID: 39825357 PMCID: PMC11740337 DOI: 10.1186/s12888-025-06494-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 01/10/2025] [Indexed: 01/20/2025] Open
Abstract
BACKGROUND The impact of childhood cancer extends beyond the affected child, significantly influencing the mental health of their families. Since research in psycho-oncology has been carried out almost exclusively in high-income countries, little is known about the impact of childhood cancer on the family level in low- and middle income countries (LMICs). This is a notable gap in the evidence-base, as many LMICs are collectivist cultures, where social and family networks are crucial elements of health care. METHODS This prospective, cross-sectional study examined the mental health of 307 Kurdish parents of children undergoing cancer treatment in the Kurdistan Region of Iraq (KRI). Data were collected through structured interviews at two major oncology hospitals in the KRI, utilizing standardized instruments to assess mental health symptoms, socioeconomic status, and social constraints. The study focused on understanding the effects of socioeconomic challenges, disease severity, and social support limitations on parental mental health. RESULTS Significant mental health challenges were observed among parents, with mothers experiencing higher symptom levels than fathers. Lower socioeconomic status was linked to poorer parental mental health. Additionally, parents of children with more severe cancer and those reporting their child's reduced engagement in daily activities experienced heightened mental health symptoms. Social constraints on expressing feelings about the child's illness further intensified parental stress, underscoring the cumulative impact of economic strain, disease severity, and limited social support on parental mental health. CONCLUSIONS The study highlights the intricate relationship between socioeconomic factors, the disease severity of the child, and social dynamics in shaping parental mental health in the context of pediatric cancer. Psychosocial interventions that target these specific stressors may aid in better supporting families, particularly those in low-resource settings.
Collapse
Affiliation(s)
- Hawkar Ibrahim
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Bielefeld University, P.O. Box 100131, Universitätsstraße 25, Bielefeld, 33501, Germany.
| | - Azad Ali Ismail
- Department of Clinical Psychology, Koya University, Koya, Kurdistan Region, Iraq
| | | | - Benjamin Iffland
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Bielefeld University, P.O. Box 100131, Universitätsstraße 25, Bielefeld, 33501, Germany
| | - Frank Neuner
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Bielefeld University, P.O. Box 100131, Universitätsstraße 25, Bielefeld, 33501, Germany
| |
Collapse
|
|
13
|
Lim HL, Suhail MK, Lim CS, Daher AM. Fear of progression, coping strategies, and associated factors among a sample of Malaysian women with breast cancer. Sci Rep 2025; 15:922. [PMID: 39762234 PMCID: PMC11704191 DOI: 10.1038/s41598-024-82143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 12/03/2024] [Indexed: 01/11/2025] Open
Abstract
Fear of progression (FoP) is a stressful psychosocial condition that affects health and quality of life. Breast cancer is recognized as the most prevalent cancer among women globally. This study aims to determine the prevalence of FoP, coping strategies, and associated factors among Malaysian female breast cancer survivors. A cross-sectional survey was conducted among 242 female breast cancer patients recruited from the south of Malaysia using simple random sampling method. The questionnaire captured sociodemographic characteristics, clinical factors, coping strategies and FoP level. Factors associated with FoP were investigated using multiple logistic regression analysis. The mean age was 55.1 (± 10.9) years. Majority of them were Malays, attained secondary ducation and above, married, unemployed, and in advanced cancer stages. Most patients had low FoP levels, with a smaller proportion having moderate-to-high FoP levels (10.7%). Higher education (AOR = 5.10, P = 0.050), being employed (AOR = 3.85, P = 0.020), advanced can cer stage (AOR = 4.23, P = 0.030), and adoption of avoidant coping strategy (AOR = 1.19, P = 0.009), were associated with higher FoP level. The level of FoP is low among Malaysian females with breast cancer. Higher levels of FoP were associated with higher educational levels, employment status, advanced cancer stage, and utilization of avoidant coping strategies. The fundamental cognitive process mainly affects FoP, rather than disease-related factors.
Collapse
Affiliation(s)
- Hui Li Lim
- School of Postgraduate Studies, IMU University, Kuala Lumpur, 57000, Malaysia
- Institute for Clinical Research, National Institutes of Health, Shah Alam, 40170, Malaysia
| | - Mohammed K Suhail
- Department of Public Health & Community Medicine, School of Medicine, IMU University, Kuala Lumpur, 57000, Malaysia
| | - Chun Sen Lim
- Oncology Department, Hospital Sultan Ismail, Johor Bahru, 81100, Malaysia
| | - Aqil M Daher
- Department of Public Health & Community Medicine, School of Medicine, IMU University, Kuala Lumpur, 57000, Malaysia.
- Department of Community Medicine, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia.
| |
Collapse
|
|
14
|
Shi D, Li R, Chen P, Zhong J, Wang K, Wang D, Zhu H. The mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies. Hematology 2024; 29:2416723. [PMID: 39466116 DOI: 10.1080/16078454.2024.2416723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 10/08/2024] [Indexed: 10/29/2024] Open
Abstract
OBJECTIVE To explore the mediating effect of shame in patients with malignant haematological diseases between fear of disease progression and social alienation. METHODS Recruiting 310 patients with haematological malignancies as the research population, the convenience sampling method was used to investigate the general information questionnaire, the fear of disease progression scale, the social influence scale and the general alienation scale. RESULTS The patients with haematological malignancies scored (36.02 ± 9.74) points for fear of disease progression, (58.02 ± 9.52) points for stigma and (31.31 ± 5.85) points for social alienation. Social alienation in patients with haematologic malignancies was positively correlated with stigma (r = 0.500, P < 0.01) and fear of disease progression (r = 0.424, P < 0.01), and fear of disease progression was also positively correlated with stigma (r = 0.405, P < 0.01). Bootstrap test results showed that the mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies was 0.159, accounting for 37.5% of the total effect. CONCLUSION The sense of shame plays an intermediary role between fear of disease progression and social alienation in patients with malignant haematological diseases. Clinical nurses should pay attention to the current situation of fear and shame in patients with such diseases and take appropriate intervention measures to reduce the occurrence of negative emotions such as social alienation.
Collapse
Affiliation(s)
- Dan Shi
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - Run Li
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - PeiXin Chen
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - JiaQing Zhong
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - KuiLi Wang
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - Dan Wang
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - HuiJuan Zhu
- Special Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, People's Republic of China
| |
Collapse
|
|
15
|
Guan X, Zhu Q, Qian H. Relationship between post-traumatic stress disorder and fear of progression in stroke patients: the mediating role of perceived social support and coping styles. Top Stroke Rehabil 2024:1-9. [PMID: 39435703 DOI: 10.1080/10749357.2024.2417646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 10/13/2024] [Indexed: 10/23/2024]
Abstract
OBJECTIVE Fear of progression (FoP) among stroke patients is closely associated with post-traumatic stress disorder (PTSD), perceived social support, and coping styles. However, there is still limited research on the mechanism of interaction among these four factors. The purpose of this study was to investigate the mediating role of coping styles and perceived social support in the relationship between FoP and PTSD among stroke patients. METHODS The study included 240 stroke patients and utilized a cross-sectional design. Data was collected using a general data questionnaire, the Fear of Progression-Questionnaire-Short Form (FoP-Q-SF), the Perceived Social Support Scale (PSSS), Medical Coping Modes Questionnaire (MCMQ), and the Post-traumatic Stress Disorder Check-list-Civilian Version (PCL-C). Structural equation modeling was used to assess the mediating relationship between PSSS and MCMQ between FoP and PTSD. RESULT A total of 112 (46.7%) patients exhibited mental dysfunction with FoP scores ≥34, and 89 (37.1%) patients presented with a PTSD score of at least 38 had certain PTSD symptoms. FoP was negatively correlated with PSSS and facing coping styles, and positively correlated with PTSD and yielding coping styles. PSSS, facing coping styles, and yielding coping styles partially mediated the relationship between FoP and PTSD, accounting for 42.69% of the total effect. CONCLUSION PTSD can impact FoP directly or indirectly through perceived social support, confrontation, and submissive coping styles. Therefore, it is important to urge patients to reasonably use social support and coping styles to increase well-being, and strive to mitigate the ongoing impact of PTSD symptoms, and reduce the risk of FoP.
Collapse
Affiliation(s)
- Xuechun Guan
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Qinyuan Zhu
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Hailan Qian
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| |
Collapse
|
|
16
|
Michel A, Dorval M, Chiquette J, Savard J. Fear of cancer recurrence in breast cancer survivors carrying a BRCA1 or 2 genetic mutation : a cross-sectional study. Hered Cancer Clin Pract 2024; 22:16. [PMID: 39192282 DOI: 10.1186/s13053-024-00285-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) affects virtually all patients who have been treated for cancer, to varying degrees. Breast cancer survivors who carry a BRCA1 or BRCA2 gene mutation are at high risk of cancer recurrence. No study has yet assessed FCR specifically in this population. OBJECTIVES This cross-sectional study, conducted in women who were treated for breast cancer and carrying a BRCA1/2 mutation, aimed to: (1) assess the mean level of FCR and estimate the proportion of patients with clinical levels of FCR; (2) examine the relationships between FCR and selected psychological variables (e.g., avoidance, intolerance to uncertainty) and quality of life; (3) explore whether FCR levels vary as a function of the past preventive treatment received; and (4) to assess the associations between FCR and the presence of decisional conflict or regret regarding the various preventive options. METHOD Participants were recruited through an e-mail sent to an oncogenetic network mailing list (Réseau ROSE). Participants were asked to complete a battery of questionnaires online assessing FCR and other psychological and quality of life variables. RESULTS A total of 89 women completed the survey. Most participants had undergone a preventive mastectomy (62.9%) and a preventive salpingo-oophorectomy (75.3%) at the time of the study. The mean Fear of Cancer Recurrence Inventory-severity score was 16.8, which exceeds the clinical cut-off score of 13, and 70.8% of the participants showed a clinical level of FCR. FCR was significantly associated with higher levels of anxiety and depression, and higher avoidance and intolerance of uncertainty, but not with quality of life. No significant difference was observed on the total FCR score between women who had received preventive surgery (mastectomy and/or salpingo-oophorectomy) and those considering it, and those not considering it. The association was significant between higher FRC scores and greater decisional conflicts and regrets about choosing to undergo preventive surgery. CONCLUSION These data suggest that FCR is a significant problem for breast cancer survivors carrying a BRCA1/2 genetic mutation, even after undergoing a prophylactic surgery. This highlights the importance of providing these women with specific psychological intervention focusing on FCR.
Collapse
Affiliation(s)
- Alexandra Michel
- School of Psychology, Université Laval, Québec, Canada
- CHU de Québec-Université Laval Research Center, Québec, Canada
- Université Laval Cancer Research Center, Centre intégré de cancérologie du CHU de Québec-Université, Laval Hôpital de l'Enfant-Jésus, Québec, 1401 18e Rue, G1J 1Z4, Canada
| | - Michel Dorval
- CHU de Québec-Université Laval Research Center, Québec, Canada
- Université Laval Cancer Research Center, Centre intégré de cancérologie du CHU de Québec-Université, Laval Hôpital de l'Enfant-Jésus, Québec, 1401 18e Rue, G1J 1Z4, Canada
- Faculty of Pharmacy, Université Laval, Québec, Canada
- CISSS de Chaudière-Appalaches Research Center, Levis, Canada
| | - Jocelyne Chiquette
- CHU de Québec-Université Laval Research Center, Québec, Canada
- Université Laval Cancer Research Center, Centre intégré de cancérologie du CHU de Québec-Université, Laval Hôpital de l'Enfant-Jésus, Québec, 1401 18e Rue, G1J 1Z4, Canada
- Faculty of Medicine, Université Laval, Québec, Canada
| | - Josée Savard
- School of Psychology, Université Laval, Québec, Canada.
- CHU de Québec-Université Laval Research Center, Québec, Canada.
- Université Laval Cancer Research Center, Centre intégré de cancérologie du CHU de Québec-Université, Laval Hôpital de l'Enfant-Jésus, Québec, 1401 18e Rue, G1J 1Z4, Canada.
| |
Collapse
|
|
17
|
Sheng L, Zhu Y, Liu Y, Hua H, Zhou J, Ye L. Fear of cancer recurrence and associated factors in family caregivers of patients with hematologic malignancy receiving chemotherapy: A latent profile analysis. Asia Pac J Oncol Nurs 2024; 11:100382. [PMID: 38495640 PMCID: PMC10940887 DOI: 10.1016/j.apjon.2024.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/13/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study identified the potential subgroups of fear of cancer recurrence (FCR) in family caregivers (FCs) of patients with hematologic malignancies receiving chemotherapy, as well as exploring factors associated with subgroups. Methods This was a cross-sectional study involving 206 pairs of participating patients with hematologic malignancies receiving chemotherapy and their FCs. Using Mplus 8.3 to perform the latent profile analysis of FCs' FCR, the FCs' burden, quality of life, psychological resilience, and anxiety as well as their demographic characteristics were compared between the subgroups, with a logistic regression analysis being applied to examine the factors associated with the FCR subgroups. Results A total of 206 FCs were classified into two subgroups: "a low level of FCR" (Class 1, 65.4%) and "a high level of FCR" (Class 2, 34.6%). Quality of life, anxiety, and frequency of chemotherapy were significantly associated with the two subgroups. Conclusions FCs of patients with hematologic malignancy receiving chemotherapy had two FCR subgroups, "a low level of FCR" and "a high level of FCR", in association with quality of life, anxiety, and frequency of chemotherapy. These findings provide the theoretical foundations for screening the FCR factor of FCs and conducting interventions for them.
Collapse
Affiliation(s)
- Li Sheng
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yingying Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yajiao Liu
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Haiying Hua
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jingfen Zhou
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Long Ye
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
| |
Collapse
|
|
18
|
Zhu X, Ren G, Wang J, Yan Y, Du X. A multiple linear regression analysis identifies factors associated with fear of cancer recurrence in postoperative patients with gastric cancer. Medicine (Baltimore) 2024; 103:e35110. [PMID: 38489733 PMCID: PMC10939660 DOI: 10.1097/md.0000000000035110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/11/2023] [Accepted: 08/16/2023] [Indexed: 03/17/2024] Open
Abstract
To investigate the risk factors of fear of cancer recurrence (FCR) in postoperative patients with gastric cancer (GC) and provide references for targeted nursing intervention development. A total of 84 patients who underwent GC surgery were included in this study. The fear of progression questionnaire-short form and social support rating scale were conducted, and multiple linear regression was performed to identify risk factors of FCR. The score of the fear of progression questionnaire-short form in patients with GC surgery was 39.1 ± 7.6. The results of multiple linear regression showed that age, education level, occupational status, course of the disease, Tumor node metastasis staging, and social support were the influencing factors of FCR in patients with GC (P < .05). The current situation of FCR in patients with GC surgery is not optimistic. The medical staff should pay more attention to patients with low age, low education level, unemployment, short course, high tumor node metastasis staging, low social support level, and other high-risk groups, and provide social support resources to reduce the level of FCR.
Collapse
Affiliation(s)
- Xuejuan Zhu
- Gastroenterology Department, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Guijun Ren
- Department of Hepatobiliary Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Junmin Wang
- Gastroenterology Department, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Yajuan Yan
- Gastroenterology Department, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Xian Du
- Gastroenterology Department, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| |
Collapse
|
|
19
|
Du YJ, Guan YH, Thome KT, Dong JC. Music Therapy and Music Intervention for NSCLC Patients Undergoing PET with Fear of Cancer Recurrence. Integr Cancer Ther 2024; 23:15347354241269898. [PMID: 39135426 PMCID: PMC11322939 DOI: 10.1177/15347354241269898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/18/2023] [Accepted: 07/19/2024] [Indexed: 08/16/2024] Open
Abstract
Background: Cancer and psychiatric symptoms are associated. Fear of cancer recurrence (FCR) is the most common psychological problem for cancer survivors. Pharmacological interventions can help, but also have major drawbacks. Music therapy and music interventions have been shown to be a safe and practical complementary treatment. Objective: This randomized, controlled trial aimed to investigate the effects of music therapy and music intervention in attenuating non-small cell lung cancer (NSCLC) patients' anxiety related to FCR. Methods: NSCLC patients with FCR were randomly allocated to a music therapy and intervention group (G1) and Control group (G2). Patients' anxiety was measured using the State-Trait Anxiety Inventory scores and heart rates. Primary outcome measure were PET scans. Secondary measures were salivary cortisol, salivary α-amylase levels and heart rate. Findings: Patients in G1 showed higher glucose metabolism of 18F-FDG in the superior frontal gyrus, anterior cingulate, superior temporal gyrus, and parahippocampal gyrus, compared to those in G2 (all P < .001). Heart rates and salivary α-amylase area under the curve (AUC) and relative variation (VAR) in G1 were significantly lower than those in G2 (all P < .05). State-Trait Anxiety Inventory scores and cortisol AUC in G1 were significantly lower than those in G2 (all P < .05). Conclusions: Music therapy and interventions can reduce anxiety and endocrinological responses and change glucose metabolism of 18F-FDG in fear-related brain regions.Trial registration: Registered retrospectively, ISRCTN Registry, www.isrctn.com, ISRCTN23276302Clinical Implications: Cancer treatment centers and physical examination centers should consider providing music therapy and intervention to the appropriate patients as a routine component of a comprehensive clinical care during medical examinations.
Collapse
Affiliation(s)
- Yi-jie Du
- Qingpu Traditional Chinese Medicine Hospital, Shanghai, China
| | | | | | | |
Collapse
|
|
20
|
Faraji A, Dehghani M, Khatibi A. Familial aspects of fear of cancer recurrence: current insights and knowledge gaps. Front Psychol 2023; 14:1279098. [PMID: 38034286 PMCID: PMC10684928 DOI: 10.3389/fpsyg.2023.1279098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Fear of cancer recurrence is fear or worry about cancer recurrence or progress. Fear of recurrence can impact patients' quality of life and wellbeing. Cancer survivors' families support them practically and emotionally, making them a vital supplement for official healthcare. Given the well-established important role of the family in dealing with cancer, we compiled the studies that examined the relationship between family-related factors and fear of cancer recurrence (FCR) among cancer survivors (CSs). One of the foremost studies in this field is the FCR model presented by Mellon and colleagues, which included concurrent family stressors and family-caregiver FCR as factors linked to survivor FCR. Our goal was to prepare the ground for a family-based model of FCR that is more comprehensive than the one proposed by Mellon et al. sixteen years ago. The studies included those with samples of adult cancer survivors from different regions of the world. Most of the studies we reviewed are cross-sectional studies. We categorized family-related factors associated with survivor FCR into partner-related factors, including subgroups of disclosure to partner, cognitions of partner, and partner's sources of support; parenthood-related factors, including having children and parenting stress; family-related factors, including living situation, family history of cancer, family's perception of the illness, and family characteristics; and social interactions including social support, disclosure, social constraints, and attitudes of others. This review sheds light on how significant others of cancer survivors can affect and be affected by cancer-related concerns of survivors and emphasizes the necessity of further investigation of family-related factors associated with FCR.
Collapse
Affiliation(s)
- Aida Faraji
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Dehghani
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health (IMH), School of Psychology, University of Birmingham, Birmingham, United Kingdom
- The Centre for Human Brain Health (CHBH), School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
|
21
|
Ahn J, Lee KE. A hermeneutic phenomenological study on the disease experience among young women with breast cancer. Asia Pac J Oncol Nurs 2023; 10:100310. [PMID: 37916000 PMCID: PMC10616147 DOI: 10.1016/j.apjon.2023.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023] Open
Abstract
Objective Women diagnosed with breast cancer under the age of 40 face distinctive physical and psychosocial challenges resulting from the disease's pathological features and the developmental aspects associated with their youth. This study aims to investigate the lived experience of breast cancer among this group of young women. Methods Participants were purposefully selected from online communities and chat rooms in South Korea. A total of 15 young women with breast cancer were included in this study, and data were gathered through three focus group interviews. The interviews were transcribed verbatim and analyzed using the hermeneutic phenomenology method. Results Four essential themes emerged based on four lifeworld existentials: lived body, lived time, lived space, and lived others. These four essential themes were: a wounded and sick body, life robbed of youth and elderly years, crossroads of growth discovered at life's extremes, and a steadfast companion on a solitary journey. Conclusions Young women with breast cancer face unique challenges due to the intersection of a severe illness and its impact during their formative years. This study offers valuable insights for crafting customized interventions that directly target the physical and psychosocial requirements of young breast cancer survivors, ultimately enhancing their quality of life.
Collapse
Affiliation(s)
- Jeonghee Ahn
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung-eun Lee
- Department of Nursing Science, SunMoon University, Asan, Republic of Korea
| |
Collapse
|
|
22
|
Shi Y, Dai J, Kuai B, Su X, Yang R, Gong S, Guo Y. Impact of fear of recurrence in patients with cancer on caregivers' psychological health: A meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100299. [PMID: 37780398 PMCID: PMC10534230 DOI: 10.1016/j.apjon.2023.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study aims to quantitatively investigate the relationship between fear of cancer recurrence in patients with cancer and their caregivers' psychological health, examining the extent of the impact of this fear on caregivers. Methods We conducted a comprehensive search in PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO databases from inception until May 2023 for relevant English publications. Pearson correlation coefficients (r) were utilized as effect sizes to assess the overall relationship between fear of recurrence and psychological outcomes among caregivers of patients with cancer. Results A total of 19 eligible studies were included in the analysis. The findings revealed a moderate positive correlation between fear of recurrence in patients with cancer and caregivers' fear of recurrence and depression. A relatively weaker correlation was observed between patients' fear of recurrence and caregivers' anxiety. Due to considerable heterogeneity (I2 = 91.99%, Q = 212.23), the primary outcome of fear of recurrence in patients with cancer influencing caregivers' fear of recurrence was examined through subgroup analyses. Conclusions Our meta-analysis established a significant positive correlation between fear of recurrence in patients with cancer and negative psychological consequences among caregivers, including recurrence fear, depression, and anxiety. Future research should explore the evolution of adverse psychological outcomes in both patients with cancer and their caregivers over time and delve into the bivariate psychological impact within the patient-caregiver dyads. Systematic review registration PROSPERO, CRD42022383866.
Collapse
Affiliation(s)
- Yue Shi
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Jingjing Dai
- Department of Oral Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Benxin Kuai
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Xiaoqin Su
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Runze Yang
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Shujin Gong
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Yujie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| |
Collapse
|
|
23
|
Webb K, Sharpe L, Butow P, Dhillon H, Zachariae R, Tauber NM, O'Toole MS, Shaw J. Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies. Psychooncology 2023; 32:1173-1191. [PMID: 37303263 DOI: 10.1002/pon.6176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures. METHODS CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906). RESULTS Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most. CONCLUSIONS Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
Collapse
Affiliation(s)
- Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Haryana Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark
| | - Nina Møller Tauber
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| |
Collapse
|
|
24
|
Neves MC, Bártolo A, Prins JB, Sales CMD, Monteiro S. Taking Care of an Adolescent and Young Adult Cancer Survivor: A Systematic Review of the Impact of Cancer on Family Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085488. [PMID: 37107768 PMCID: PMC10138338 DOI: 10.3390/ijerph20085488] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/15/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
Research usually investigates adolescents and young adults (AYA) with cancer in combination with younger and older cancer patients and survivors. However, AYAs with cancer are a unique group, and their caregivers' experience may also differ from other caregivers of cancer survivors. This systematic review aims to understand the impact of a cancer diagnosis on family caregivers, comparing the experience of caregivers of AYA childhood cancer survivors (AYA CCS) and caregivers of AYA with cancer. Relevant studies were identified through PubMed, Scopus, and Web of Science databases, and their quality was assessed using the Joanna Briggs Institute's critical appraisal checklists. Sixteen studies (17 reports) met the inclusion criteria. Findings were synthesized separately for caregivers of AYA CCS and caregivers of AYA with cancer. Results showed that caregivers in both groups experienced high distress after the diagnosis. Partners of AYAs with cancer experienced diminished quality of life (QoL) and over half reported moderate to high fear of cancer recurrence (FCR). Findings indicated that cancer negatively impacts family caregivers, regardless of the patient's age at diagnosis. However, findings are heterogeneous, and most do not focus on QoL or FCR. More research is needed on the impact of cancer among these family caregivers.
Collapse
Affiliation(s)
- Maria Carolina Neves
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
- Correspondence:
| | - Ana Bártolo
- I2P—Portucalense Institute of Psychology, 4200-072 Porto, Portugal
- RECI—Research in Education and Community Intervention, Piaget Institute—ISEIT/Viseu, 3515-776 Viseu, Portugal
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Judith B. Prins
- Department of Medical Psychology, Radboud University Medical Centre, 6500 HB Nijmegen, The Netherlands
| | - Célia M. D. Sales
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Sara Monteiro
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
- Departament of Social Sciences and Management, Open University, 1269-001 Lisboa, Portugal
- Center for Global Studies, Open University, 1269-001 Lisboa, Portugal
| |
Collapse
|
|
25
|
Lu X, Wu C, Bai D, You Q, Cai M, Wang W, Hou C, Gao J. Relationship between social support and fear of cancer recurrence among Chinese cancer patients: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1136013. [PMID: 36970291 PMCID: PMC10031045 DOI: 10.3389/fpsyt.2023.1136013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/23/2023] [Indexed: 03/29/2023] Open
Abstract
Background To quantitatively analyze the association between social support (SS) and fear of cancer recurrence (FCR) by reviewing current evidence from observational studies. Methods A comprehensive literature search was performed in nine databases from inception to May 2022. Observational studies that used both SS and FCR as study variables were included. Regression coefficient (β') and correlation coefficient (r) were calculated with R software. Subgroup analysis was utilized to investigate the degree of the relationship between SS and FCR as well as the impact of various forms of SS on FCR in cancer patients. Results Thirty-seven studies involving 8,190 participants were identified. SS significantly reduced FCR risk [pooled β' = -0.27, 95% confidence interval (CI) = -0.364 to -0.172], with moderate negative correlations (summary r = -0.52, 95% CI = -0.592 to -0.438). Meta-regression and subgroup analysis showed that types of cancer and study type were the source of heterogeneity. However, types of SS [actual SS, perceived social support (PSS), and others], source of actual SS, and source of PSS were not significant moderators. Conclusion To the best of our knowledge, this is the first systematic review and meta-analysis to quantitatively investigate the association between SS and FCR in Chinese cancer patients using β' and r coefficients. The results re-emphasized that social workers should enhance the use of SS by cancer patients and establish a sound SS system by either implementing more relevant research or developing targeted policies. Based on meta-regression and subgroup analyses, moderators of the association between SS and FCR should also be studied closely as they may help identify patients in need. In addition, longitudinal research, as well as mixed research, should be conducted to more comprehensively explore the relationship between SS and FCR. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42022332718.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Chaoming Hou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
|
26
|
Kazzi B, Chino F, Kazzi B, Jain B, Tian S, Paguio JA, Yao JS, Muralidhar V, Mahal BA, Nguyen PL, Sanford NN, Dee EC. Shared burden: the association between cancer diagnosis, financial toxicity, and healthcare cost-related coping mechanisms by family members of non-elderly patients in the USA. Support Care Cancer 2022; 30:8905-8917. [PMID: 35877007 DOI: 10.1007/s00520-022-07234-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 06/14/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE There has been little research on the healthcare cost-related coping mechanisms of families of patients with cancer. Therefore, we assessed the association between a cancer diagnosis and the healthcare cost-related coping mechanisms of participant family members through their decision to forego or delay seeking medical care, one of the manifestations of financial toxicity. METHODS Using data from the National Health Interview Survey (NHIS) between 2000 and 2018, sample weight-adjusted prevalence was calculated and multivariable logistic regressions defined adjusted odds ratios (aORs) for participant family members who needed but did not get medical care or who delayed seeking medical care due to cost in the past 12 months, adjusting for relevant sociodemographic covariates, including participant history of cancer (yes vs. no) and participant age (18-45 vs. 46-64 years old). The analysis of family members foregoing or delaying medical care was repeated using a cancer diagnosis * age interaction term. RESULTS Participants with cancer were more likely than those without a history of cancer to report family members delaying (19.63% vs. 16.31%, P < 0.001) or foregoing (14.53% vs. 12.35%, P = 0.001) medical care. Participants with cancer in the 18 to 45 years old age range were more likely to report family members delaying (pinteraction = 0.028) or foregoing (pinteraction < 0.001) medical care. Other factors associated with cost-related coping mechanisms undertaken by the participants' family members included female sex, non-married status, poorer health status, lack of health insurance coverage, and lower household income. CONCLUSION A cancer diagnosis may be associated with familial healthcare cost-related coping mechanisms, one of the manifestations of financial toxicity. This is seen through delayed/omitted medical care of family members of people with a history of cancer, an association that may be stronger among young adult cancer survivors. These findings underscore the need to further explore how financial toxicity associated with a cancer diagnosis can affect patients' family members and to design interventions to mitigate healthcare cost-related coping mechanisms.
Collapse
Affiliation(s)
- Bahaa Kazzi
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 02446, USA
| | - Brigitte Kazzi
- Department of Internal Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bhav Jain
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sibo Tian
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph A Paguio
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - J Seth Yao
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | | | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nina N Sanford
- Department of Radiation Oncology, University of Texas Southwestern, 2280 Inwood Road, Dallas, TX, 75235, USA.
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 02446, USA.
| |
Collapse
|
|
27
|
Parker PD, Prabhu AV, Su LJ, Zorn KK, Greene CJ, Hadden KB, McSweeney JC. What's in Between the Lines: Assessing the Readability, Understandability, and Actionability in Breast Cancer Survivorship Print Materials. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1532-1539. [PMID: 33822316 PMCID: PMC8492775 DOI: 10.1007/s13187-021-02003-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Educational print materials for young women breast cancer survivors (YBCS) are supplemental tools used in patient teaching. However, the readability of the text coupled with how well YBCS understand or act upon the material are rarely explored. The purpose of this study was to assess the readability, understandability, and actionability of commonly distributed breast cancer survivorship print materials. We used an environmental scan approach to obtain a sample of breast cancer survivorship print materials available in outpatient oncology clinics in the central region of a largely rural Southern state. The readability analyses were completed using the Flesch-Kincaid (F-K), Fry Graph Readability Formula (Fry), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were analyzed using Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). The environmental scan resulted in a final sample of 14 materials. The mean readability of the majority of survivorship materials was "difficult," but the majority scored above the recommended 70% in both understandability and actionability. The importance of understandability and actionability may outweigh readability results in cancer education survivorship material. While reading grade level cannot be dismissed all together, we surmise that patient behavior may hinge more on other factors such as understandability and actionability. Personalized teaching accompanying print material may help YBCS comprehend key messages and promote acting upon specific tasks.
Collapse
Affiliation(s)
- Pearman D Parker
- College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #529, Little Rock, Arkansas, 72205, USA.
| | - Arpan V Prabhu
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - L Joseph Su
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kristin K Zorn
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Carolyn J Greene
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kristie B Hadden
- University of Arkansas for Medical Sciences, UAMS Health, Little Rock, Arkansas, USA
| | - Jean C McSweeney
- College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #529, Little Rock, Arkansas, 72205, USA
| |
Collapse
|
|
28
|
Jennings A, O'Connor L, Durand H, Finnerty M. Women's psychosexual experiences following radical radiotherapy for gynaecological cancer: A qualitative exploration. J Psychosoc Oncol 2022; 41:355-371. [PMID: 36073853 DOI: 10.1080/07347332.2022.2114054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To explore psychosexual experiences of women following radical radiotherapy for gynaecological cancer. METHODS Seven women who had completed radical radiotherapy for gynaecological cancer were interviewed. Interviews were semi-structured, and data were analyzed using an interpretative phenomenological analysis (IPA) approach. RESULTS Five superordinate themes were constructed: (1) No desire for sex since completing treatment; (2) Fear; (3) Unmet information and support needs; (4) Partner support and needs; and (5) Communication. Fear of adverse consequences following sex inhibited return to sexual activity after treatment. Misconceptions and lack of knowledge were evident. Communicating sexual issues was a difficulty that transcended personal relationships, also evident in professional medical relationships. CONCLUSION Simple measures, beginning with facilitating understanding and acceptance of psychosexual experiences, can help those experiencing psychosexual problems following radical radiotherapy. Encouraging discussion, providing options and practical knowledge, and clarifying misconceptions about risks from sex after cancer could improve outcomes for gynaecological cancer patients.
Collapse
Affiliation(s)
- Aoife Jennings
- Radiotherapy, University Hospital Galway (UHG), Galway, Ireland
| | - Laura O'Connor
- HRB Primary Care Clinical Trials Network Ireland, National University of Ireland, Galway, Galway, Ireland
| | - Hannah Durand
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | - Martina Finnerty
- Irish College of Humanities & Applied Sciences (ICHAS), Limerick, Ireland
| |
Collapse
|
|
29
|
Yang Y, Sun H, Luo X, Li W, Yang F, Xu W, Ding K, Zhou J, Liu W, Garg S, Jackson T, Chen Y, Xiang YT. Network connectivity between fear of cancer recurrence, anxiety, and depression in breast cancer patients. J Affect Disord 2022; 309:358-367. [PMID: 35472477 DOI: 10.1016/j.jad.2022.04.119] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fear of cancer recurrence (FCR), anxiety, and depression are common psychological disturbances that frequently occur together among cancer patients. This study investigated network connectivity between FCR, anxiety, and depressive symptoms in a large representative sample of breast cancer patients. METHODS This was a multicenter, cross-sectional study of 803 women with breast cancer. All participants completed the 4-item FCR scale, Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire (PHQ-9). Network analysis was conducted to investigate the network structure, central symptoms, bridge symptoms, and network stability of these disturbances. RESULTS The generated network model indicated that anxiety and depression symptom communities were well-connected with each other, while FCR emerged as a distinct cluster with only a few weak links to anxiety and depression communities. Depressive and anxiety symptoms were more central than FCR symptoms were in the model. 'Having trouble relaxing' (#GAD4, strength = 1.147) was the most central node within the whole network, and 'strong feelings about recurrence' (#FCR4, strength = 0.531) was the least central node. Several anxiety symptoms (e.g., 'feeling afraid', 'uncontrollable worry', and 'restlessness') acted as important bridging symptoms connecting FCR, depression and anxiety communities. 'Uncontrollable worry' (#GAD2) had the highest node-specific predictive betweenness value. The network stability of this model was high. CONCLUSION Depression and anxiety symptoms are highly interactive with each other among women with breast cancer. Conversely, FCR may have attenuated relations with anxiety and depression communities and emerged as a relatively independent, unique experience. Anxiety symptoms, particularly 'uncontrollable worry', acted as important trans-diagnostic symptoms that connected different communities. Findings suggested interventions to alleviate excessive worries and enhance feelings of personal control might be helpful in preventing or reducing related symptoms of FCR, anxiety and depression.
Collapse
Affiliation(s)
- Yuan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou 510515, China
| | - Wengao Li
- Department of Psychiatry, 999 Brain Hospital, Guangzhou 510515, China
| | - Fan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Wenjing Xu
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Kairong Ding
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jiangyan Zhou
- Department of Psychiatry, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Wenting Liu
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9BL, UK
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou 510515, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
| |
Collapse
|
|
30
|
Guil R, Ruiz-González P, Morales-Sánchez L, Gómez-Molinero R, Gil-Olarte P. Idiosyncratic Profile of Perceived Emotional Intelligence and Post-Traumatic Growth in Breast Cancer Survivors: Findings of a Multiple Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148592. [PMID: 35886445 PMCID: PMC9316763 DOI: 10.3390/ijerph19148592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023]
Abstract
Psycho-oncology research suggests that positive personal changes can occur after experiencing breast cancer. These changes can be understood as post-traumatic growth (PTG) and seem to be determined by emotional self-efficacy perception. This study aims to investigate the existence of different profiles of PTG and perceived emotional intelligence (PEI) among breast cancer survivors (BCSs) and healthy controls. Moreover, it aims to study the mechanisms through which PEI may mediate the relationship between disease survival and PTG. The total sample was 636 women divided into two groups: 56 BCS and 580 healthy controls who completed TMMS-24 and PTGI. The results displayed that BCSs apparently show a different profile of PTG and PEI compared to healthy women. The mediation analyses showed that survivorship explained 1.9% of PTG, increasing to 26.5% by the effect of PEI. An indirect effect showed that cancer survival predicts reduced levels of emotional attention, decreasing PTG. However, the most statistical indirect effect evidenced that BCSs regulate their emotions appropriately, having a powerful effect on PTG and counteracting the negative effects of poor emotional attention. Knowing the implications of PEI on PTG could improve follow-up from the time of diagnosis and supporting the patient to cope with the sequelae of the disease.
Collapse
Affiliation(s)
- Rocío Guil
- Department of Psychology, University of Cádiz, 11519 Cádiz, Spain; (R.G.); (L.M.-S.); (R.G.-M.)
- Institute for Research and Innovation in Biomedical Sciences of Cádiz (INIBICA), 11009 Cádiz, Spain
- University Research Institute for Sustainable Social Development (INDESS), University of Cádiz, 11406 Cádiz, Spain
| | - Paula Ruiz-González
- Department of Psychology, University of Cádiz, 11519 Cádiz, Spain; (R.G.); (L.M.-S.); (R.G.-M.)
- Institute for Research and Innovation in Biomedical Sciences of Cádiz (INIBICA), 11009 Cádiz, Spain
- University Research Institute for Sustainable Social Development (INDESS), University of Cádiz, 11406 Cádiz, Spain
- Correspondence: (P.R.-G.); (P.G.-O.)
| | - Lucía Morales-Sánchez
- Department of Psychology, University of Cádiz, 11519 Cádiz, Spain; (R.G.); (L.M.-S.); (R.G.-M.)
- Institute for Research and Innovation in Biomedical Sciences of Cádiz (INIBICA), 11009 Cádiz, Spain
- University Research Institute for Sustainable Social Development (INDESS), University of Cádiz, 11406 Cádiz, Spain
| | - Rocío Gómez-Molinero
- Department of Psychology, University of Cádiz, 11519 Cádiz, Spain; (R.G.); (L.M.-S.); (R.G.-M.)
- Institute for Research and Innovation in Biomedical Sciences of Cádiz (INIBICA), 11009 Cádiz, Spain
- University Research Institute for Sustainable Social Development (INDESS), University of Cádiz, 11406 Cádiz, Spain
| | - Paloma Gil-Olarte
- Department of Psychology, University of Cádiz, 11519 Cádiz, Spain; (R.G.); (L.M.-S.); (R.G.-M.)
- Institute for Research and Innovation in Biomedical Sciences of Cádiz (INIBICA), 11009 Cádiz, Spain
- University Research Institute for Sustainable Social Development (INDESS), University of Cádiz, 11406 Cádiz, Spain
- Correspondence: (P.R.-G.); (P.G.-O.)
| |
Collapse
|
|
31
|
Geiss C, Chavez MN, Oswald LB, Ketcher D, Reblin M, Bandera EV, Savard J, Zhou ES, Fox RS, Jim HSL, Gonzalez BD. "I Beat Cancer to Feel Sick:" Qualitative Experiences of Sleep Disturbance in Black Breast Cancer Survivors and Recommendations for Culturally Targeted Sleep Interventions. Ann Behav Med 2022; 56:1110-1115. [PMID: 35759312 DOI: 10.1093/abm/kaac035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sleep disturbance is common and distressing among cancer survivors. Black breast cancer survivors (BBCS) suffer disproportionately from sleep disturbance, yet there is limited research on how to address this issue. PURPOSE This study aimed to understand the multifaceted experiences of sleep disturbance among BBCS and how to culturally target a mobile health (mHealth) intervention to improve sleep outcomes in BBCS. METHODS Semi-structured interviews were conducted in a purposive sample of 10 BBCS. Interviews were audio-recorded, transcribed, and coded for key barriers to sleep and potential solutions to incorporate into behavioral interventions using NVivo 12. Inductive applied thematic analysis techniques were employed to identify emergent themes. RESULTS Ten BBCS (mean age = 54, SD = 10) described their experiences of sleep disturbance with themes including: (1) barriers to quality sleep (e.g., cancer worry, personal responsibilities), (2) psychosocial impacts of sleep disturbance (e.g., fatigue, distress), and (3) commonly used strategies to improve sleep. The second section discusses suggestions for developing mHealth interventions to improve sleep for BBCS including: (1) feedback on an existing mHealth intervention and (2) intervention topics suggested by BBCS. CONCLUSIONS Our findings highlight the challenges associated with sleep disturbance in BBCS. Participants report culturally targeted mHealth interventions are needed for BBCS who experience chronic sleep disturbance that affects their overall quality of life. These interventions should address coping with sleep-related issues relevant to many breast cancer survivors and BBCS (e.g., sexual intimacy, fear of cancer recurrence) and should incorporate intervention strategies acceptable to BBCS (e.g., prayer, meditation).
Collapse
Affiliation(s)
- Carley Geiss
- Participant Research, Interventions, and Measurements (PRISM) Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Melody N Chavez
- Participant Research, Interventions, and Measurements (PRISM) Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana Ketcher
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Elisa V Bandera
- Division of Cancer Epidemiology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Josée Savard
- School of Psychology, Université Laval, Quebec, Canada.,CHU de Québec-Université Laval Research Center, Université Laval, Quebec, Canada
| | - Eric S Zhou
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rina S Fox
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| |
Collapse
|
|
32
|
Al-Kaylani HM, Loeffler BT, Mott SL, Curry M, Phadke S, van der Plas E. Characterizing Early Changes in Quality of Life in Young Women With Breast Cancer. Front Psychol 2022; 13:871194. [PMID: 35645920 PMCID: PMC9132041 DOI: 10.3389/fpsyg.2022.871194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Younger age at diagnosis is a risk factor for poor health-related quality of life (HRQOL) in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer (i.e., diagnosed prior to age 40), nor have early changes in HRQOL been fully characterized. Methods Eligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and comorbidities (e.g., depression/anxiety) were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores. Results Health-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5 (95% confidence limits [CI] = 103.7, 113.3). Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points (95% CI = 2.1, 11.1, p < 0.01), functional well-being improved 3.0 points (95% CI = 2.0, 4.1, p < 0.01), emotional well-being improved 1.9 points (95% CI = 0.9, 2.8, p < 0.01), and physical well-being improved 1.5 points (95% CI = 0.2, 2.8, p = 0.03), on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being (change: 12.9, 95% CI = 6.4, 9.5) and functional well-being (change: 5.2, 95% CI = 3.5, 6.9) than participants who did not have anxiety/depression at baseline (change in FACT-B overall well-being: 4.9, 95% CI = 0.2, 9.7; change in functional well-being: 2.3, 95% CI = 1.1, 3.4). Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal. Conclusion Young women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment.
Collapse
Affiliation(s)
- Hend M Al-Kaylani
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Bradley T Loeffler
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Melissa Curry
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sneha Phadke
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Ellen van der Plas
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| |
Collapse
|
|
33
|
Traboulssi M, Pidgeon M, Weathers E. My Wife Has Breast Cancer: The Lived Experience of Arab Men. Semin Oncol Nurs 2022; 38:151307. [DOI: 10.1016/j.soncn.2022.151307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022]
|
|
34
|
Shen Z, Xie J, Ruan C, Li C. Mediating effect of ill perception on the relationship between social constraints and fear of cancer recurrence among adolescent and young adult survivors who underwent hematopoietic stem cell transplantation. Asia Pac J Oncol Nurs 2022; 9:100060. [PMID: 35619654 PMCID: PMC9126777 DOI: 10.1016/j.apjon.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Zhiying Shen
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianfei Xie
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunhong Ruan
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- Corresponding authors.
| | - Chengyuan Li
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- Corresponding authors.
| |
Collapse
|
|
35
|
Llave K, Hoyt MA. Social constraints and cancer-related quality of life in single and partnered young adult testicular cancer survivors: a contextual approach. J Psychosoc Oncol 2022; 40:743-755. [PMID: 35068347 PMCID: PMC9308827 DOI: 10.1080/07347332.2021.2002995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To examine the context of relationship status on the link between friends/family social constraints (SCff) and cancer-related quality-of-life (QOL) among young adult testicular cancer survivors. Participants completed the Functional Assessment of Cancer Therapy (general version), the Social Constraints Scale (friends/family), and demographic questions. The sample included 162 young adult testicular cancer survivors. SCff, but not relationship status, significantly predicted QOL when controlling for age, time since diagnosis, education, and income. The SCff X relationship status interaction was significant such that SCff were more strongly related to lower QOL for single survivors than for partnered survivors. Focusing on friends and family support of young adult survivors, findings highlight the vulnerability of single survivors to social constraints within their diffuse social network. Interventions that target supportive exchanges in friends and family networks may be useful in improving QOL in single young adult cancer survivors.
Collapse
|
|
36
|
A systematic mixed studies review of fear of cancer recurrence in families and caregivers of adults diagnosed with cancer. J Cancer Surviv 2021; 16:1184-1219. [PMID: 34762248 DOI: 10.1007/s11764-021-01109-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 09/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) may be equally prevalent, persistent and burdensome in cancer caregivers as in survivors. This systematic review evaluated FCR prevalence, severity, correlates, course, impact and interventions in cancer caregivers. METHODS Electronic databases were searched from 1997 to May 2021. Two reviewers identified eligible peer-reviewed qualitative or quantitative studies on FCR in adult caregivers or family members of adult cancer survivors. The risk of bias was assessed using the Cochrane Risk of Bias tools for randomised and non-randomised studies and the Mixed-Methods Appraisal Tool. A narrative synthesis and thematic synthesis occurred on quantitative and qualitative studies, respectively. RESULTS Of 2418 papers identified, 70 reports (59 peer-reviewed articles, 11 postgraduate theses) from 63 studies were included. Approximately 50% of caregivers experienced FCR. Younger caregivers and those caring for survivors with worse FCR or overall health reported higher FCR. Most studies found caregivers' FCR levels were equal to or greater than survivors'. Caregivers' FCR was persistently elevated but peaked approaching survivor follow-up appointments. Caregivers' FCR was associated with poorer quality of life in caregivers and survivors. Three studies found couple-based FCR interventions were acceptable, but had limited efficacy. CONCLUSIONS FCR in caregivers is prevalent, persistent and burdensome. Younger caregivers of survivors with worse overall health or FCR are at the greatest risk. Further research on identifying and treating caregivers' FCR is required. IMPLICATIONS FOR CANCER SURVIVORS Caregiver and survivor FCR are similarly impactful and appear interrelated. Addressing FCR may improve outcomes for both cancer caregivers and survivors.
Collapse
|
|
37
|
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer survivors. Understanding the independent and potentially modifiable risk factors that contribute toward FCR seen in cancer survivors would inform future interventional trials aimed at reducing this risk. OBJECTIVE The aim of this study was to provide an evidence synthesis of factors correlated with FCR to inform the development of preventive interventions. METHODS A literature search was performed of the PsycINFO, EMBASE, and MEDLINE (PubMed) databases. Reports published from inception to 2020 focusing on the correlates of FCR with physical, psychological, and social factors were identified. Authors assessed the studies' risk of bias in accordance with the Standard Quality Assessment Criteria for Quantitative Studies (QualSyst criteria) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.3 software. RESULTS Thirty-four articles were included in this study with a total sample of more than 13 000 cancer patients. Fear of cancer recurrence was positively correlated with anxiety, depression, avoidance, chemotherapy, distress, intrusive thoughts, fatigue, rumination, and neuroticism. It was negatively correlated with optimism, age, social support, quality of life, time since diagnosis, well-being, and self-efficacy. CONCLUSIONS We identified 16 factors that are correlated with FCR, 9 positively correlated with FCR and 7 negatively correlated with FCR. IMPLICATIONS FOR PRACTICE The findings of this study provide direction for the development of precise interventions for FCR in cancer survivors and lay the foundation for the further construction of an FCR-related nursing theoretical framework.
Collapse
|
|
38
|
Martino ML, Lemmo D, Gargiulo A. A review of psychological impact of breast cancer in women below 50 years old. Health Care Women Int 2021; 42:1066-1085. [PMID: 34357855 DOI: 10.1080/07399332.2021.1901901] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A breast cancer diagnosis is a critical event with a potentially traumatic nature. In recent years there has been an increase of this illness in women aged under-fifty, a group of particular scientific interest. In this article the authors review the recent scientific literature on psychological impact of breast cancer experiences in under-50 women. Our results highlight three trajectories: clinical psychological risks; feminine-specific concerns; resources between individual and relational aspects. This overview illustrates the complexity of the effects of breast cancer in under-50women allowing to think about theoretical and psychosocial models to provide support for under-50 women during the illness experience.
Collapse
Affiliation(s)
- Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Anna Gargiulo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| |
Collapse
|
|
39
|
O'Rourke L, Fisher PL, Campbell S, Wright A, Cherry MG. Factors Associated With Fear of Cancer Recurrence in Family Caregivers of Cancer Survivors: A Systematic Review. Front Psychol 2021; 12:625654. [PMID: 34335354 PMCID: PMC8323753 DOI: 10.3389/fpsyg.2021.625654] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/08/2021] [Indexed: 11/20/2022] Open
Abstract
Objective: Fear of cancer recurrence (FCR) is a significant concern for family caregivers of cancer survivors and is associated with many adverse outcomes, including increased emotional distress and poorer quality of life. Although several theoretical models have been proposed to account for FCR in cancer survivors, their applicability to caregivers is unknown. The aim of this review was to identify clinical, demographic and psychological factors that are associated with, and predict, FCR in caregivers of cancer survivors. Method: AMED, CINAHL, Medline, PsycINFO, and Scopus were systematically searched for relevant studies reporting quantitative data on factors associated with FCR or similar constructs (e.g., worry or anxiety about cancer recurrence) in family caregivers of adult cancer survivors. Included studies were assessed for methodological quality using a standardized checklist adapted from the Agency for Healthcare Research and Quality. Results: Sixteen studies, half of which were cross-sectional, were included and summarized narratively. Non-modifiable factors, including age (n = 6) and treatment modality (n = 4), were found to be associated with increased FCR. Significant positive associations were also reported between illness perceptions and FCR (n = 3). However, there was heterogeneity across included studies with regards to factors examined and most were conducted in the USA. There were also several methodological limitations to the included studies. Conclusions: Research examining FCR in caregivers of cancer survivors has predominantly focused on demographic and clinical factors. Given the paucity of research exploring the psychological mechanisms underpinning FCR, future research should investigate theoretical underpinnings of FCR in caregivers of cancer survivors to support the development of psychological interventions for this population. Systematic Review Registration: PROSPERO, identifier [CRD42019119729].
Collapse
Affiliation(s)
- Louise O'Rourke
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Sophie Campbell
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Amelia Wright
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| |
Collapse
|
|
40
|
Soriano EC, Otto AK, LoSavio ST, Perndorfer C, Siegel SD, Laurenceau JP. Fear of Cancer Recurrence and Inhibited Disclosure: Testing the Social-Cognitive Processing Model in Couples Coping With Breast Cancer. Ann Behav Med 2021; 55:192-202. [PMID: 32608472 PMCID: PMC7980765 DOI: 10.1093/abm/kaaa043] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Withholding cancer-related concerns from one's partner (protective buffering) and feeling that one's partner is inaccessible or unresponsive to such disclosure (social constraints) are two interpersonal interaction patterns that separately have been linked to poorer adjustment to cancer. PURPOSE Guided by the Social-Cognitive Processing Model, we examined the joint effects of social constraints and protective buffering on fear of cancer recurrence (FCR) in survivors and spouses. Social constraints and protective buffering were hypothesized to emerge as independent predictors of higher FCR. METHODS Early-stage breast cancer survivors and spouses (N = 79 couples; 158 paired individuals) completed up to five repeated measures of FCR, social constraints, protective buffering, and relationship quality during the year postdiagnosis. A second-order growth curve model was estimated and extended to test the time-varying, within-person effects of social constraints and protective buffering on a latent FCR variable, controlling for relationship quality. RESULTS As hypothesized, greater social constraints and protective buffering significantly (p < .05) predicted higher concurrent FCR at the within-person level, controlling for global relationship quality and change in FCR over time. The fixed effects were found to be similar for both survivors and spouses. CONCLUSIONS Findings suggest that interaction patterns resulting in inhibited disclosure are associated with greater FCR for both survivors and spouses, consistent with the Social-Cognitive Processing Model. This work adds to the growing body of research highlighting the social context of FCR.
Collapse
Affiliation(s)
- Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Amy K Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Stefanie T LoSavio
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Newark, DE, USA
| | | |
Collapse
|
|
41
|
Yakar HK, Yilmaz B, Ozkol O, Gevher F, Celik E. Effects of art-based mandala intervention on distress and anxiety in cancer patients. Complement Ther Clin Pract 2021; 43:101331. [PMID: 33592551 DOI: 10.1016/j.ctcp.2021.101331] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study was planned to determine the effect of art-based mandala intervention on the distress and anxiety experienced by cancer patients. METHODS This semi-experimental study with a single group pretest-posttest design was performed with 12 breast cancer survival patients. The data were collected through "Patient Diagnostic Form", "Distress Thermometer", "Trait Anxiety Inventory". Patients participated in the "Art-Based Mandala Interventıon" for eight weeks, one day a week, 2 h each. The distress and anxiety levels of the patients were measured before starting the program and at the end of the program. RESULTS Cancer patients experienced moderate level of anxiety (50.66 ± 6.91) and clinically significant distress (4.08 ± 2.74). Anxiety scores of cancer patients decreased significantly after the program compared to before the program (p < 0.05). The distress scores of cancer patients increased after the program compared to before the program (p > 0.05). CONCLUSION After the art-based mandala intervention program, anxiety scores of breast cancer survival patients decreased, and distress scores increased.
Collapse
Affiliation(s)
- Hatice Karabuga Yakar
- Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey.
| | - Banu Yilmaz
- Mandala Meditation Therapy Specialist, Bachelor of Arts in Human Behavior, Newport International University, California, United States
| | - Ozan Ozkol
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
| | - Fadime Gevher
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
| | - Emine Celik
- License Graduated Nurse, Faculty of Health Sciences, Department of Nursing, Marmara University, Istanbul, Turkey
| |
Collapse
|
|
42
|
Vandendorpe B, Drouet Y, Ramiandrisoa F, Guilbert P, Costa B, Servagi-Vernat S. Psychological and physical impact in women treated for breast cancer: Need for multidisciplinary surveillance and care provision. Cancer Radiother 2021; 25:330-339. [PMID: 33446421 DOI: 10.1016/j.canrad.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Cancer survivors often experience adverse physical and psychosocial effects. Fear of recurrence is a difficulty very commonly reported in post-cancer life. The primary objective of this study was to describe post-cancer supportive care needs in patients treated for breast cancer. PATIENTS AND METHODS In this monocentric observational study, cancer survivors aged≥18years, diagnosed with breast cancer and treated in 2017 (cohort A) and in 2015 (cohort B) were administered a post-cancer needs questionnaire, and the Fear of Cancer Recurrence Inventory (severity subscale). RESULTS The study included 139 patients. Pain (51.9%), fatigue (51.9%), weight gain during treatment (35.1%), psychological difficulties (20.5%), and difficulties in marriage and sexual life (13.1%) were the complaints in the post-cancer period. There were no differences between the two cohorts. The severity subscale of the Fear of Cancer Recurrence Inventory showed 35.8% patients with a score>13. The fear of recurrence was a source of social difficulties, psychological disorders, and difficulties in marriage and sexual life. CONCLUSIONS Not only FCR, but also issues such as fatigue, pain, psychological difficulties, and difficulties in marriage and sexual life all call for a psycho-oncological follow-up. Clinical and radio-senological surveillance is essential, but it absolutely must be accompanied by a multidisciplinary follow-up, with central importance to psychological care.
Collapse
Affiliation(s)
- B Vandendorpe
- Department of Radiation Oncology, Oscar-Lambret Centre, 3, rue Frédéric-Combemale, 59000 Lille, France; Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France.
| | - Y Drouet
- Public Health Department, Léon-Bérard Centre, Lyon, France; CNRS UMR 5558 LBBE, Lyon university, Villeurbanne, France
| | - F Ramiandrisoa
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - P Guilbert
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - B Costa
- Support Care Department, Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - S Servagi-Vernat
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| |
Collapse
|
|
43
|
Murphy LK, Heathcote LC, Prussien KV, Rodriguez EM, Hewitt JA, Schwartz LE, Ferrante AC, Gerhardt CA, Vannatta K, Compas BE. Mother-child communication about possible cancer recurrence during childhood cancer survivorship. Psychooncology 2020; 30:536-545. [PMID: 33227159 DOI: 10.1002/pon.5600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Providing opportunities to communicate about possible cancer recurrence may be adaptive for youth in remission, yet parents may experience difficulty guiding discussions related to fears of cancer recurrence (FCR). This study aimed to characterize mother-child discussions about potential cancer recurrence during post-treatment survivorship and to determine predictors of maternal communication. METHODS Families (N = 67) were recruited after the child's initial cancer diagnosis (age 5-17 years) and mothers self-reported their distress (post-traumatic stress symptoms; PTSS). During survivorship 3-5 years later, mothers were video-recorded discussing cancer with their children. Presence and length of discussion about potential cancer recurrence, triggers for FCR, expressed affect, and conversational reciprocity were examined. Hierarchical regressions were used to assess maternal PTSS near the time of cancer diagnosis and child age as predictors of maternal communication. RESULTS Three-quarters of dyads spontaneously discussed risk for or fears about cancer recurrence; mothers initiated the topic more frequently than their children. Dyads discussed internal (bodily symptoms) and external (medical, social) triggers of FCR. Higher maternal PTSS at diagnosis predicted significantly lower levels of maternal positive affect (β = -0.36, p = 0.02) and higher levels of maternal negative affect (β = 0.30, p = 0.04) during discussion of recurrence 3-5 years later. Older child age significantly predicted higher levels of maternal negative affect (β = 0.35, p = 0.02). Higher maternal PTSS at diagnosis predicted shorter discussions about recurrence for younger children (β = 0.27, p = 0.02). CONCLUSIONS Understanding predictors and characteristics of mother-child discussions about recurrence can guide family-based FCR interventions, particularly those promoting communication as a supportive tool. Both maternal PTSS and child age are important to consider when developing these interventions.
Collapse
Affiliation(s)
- Lexa K Murphy
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Lauren C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kemar V Prussien
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Erin M Rodriguez
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Jackson A Hewitt
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura E Schwartz
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Amanda C Ferrante
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Cynthia A Gerhardt
- The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
| | - Kathryn Vannatta
- The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
| | - Bruce E Compas
- Department of Psychology & Human Development, Vanderbilt University, Nashville, Tennessee, USA
| |
Collapse
|
|
44
|
Vachon E, Krueger E, Champion VL, Haggstrom DA, Cella D, Cohee AA. The impact of fear of cancer recurrence on healthcare utilization among long-term breast cancer survivors recruited through ECOG-ACRIN trials. Psychooncology 2020; 30:279-286. [PMID: 33022832 DOI: 10.1002/pon.5568] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/13/2020] [Accepted: 09/30/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the relationship between fear of cancer recurrence (FCR) and healthcare utilization among long-term breast cancer survivors (BCS). METHODS In a cross-sectional survey study, 505 younger survivors (YS: ≤45 years) and 622 older survivors (OS: 55-70 years) 3-8 years from diagnosis completed a questionnaire assessing demographics, medical history, FCR, and healthcare utilization. Healthcare utilization consisted of breast cancer (BC) and non-BC-related routine and nonroutine utilization. RESULTS YS had significantly higher FCR than OS (p < 0.01). Independent of age, FCR was significantly associated with all three types of BC-related utilization (p < 0.05). In the multivariate models, we found a significant, positive interaction effect between FCR and increased comorbidities on nonroutine BC appointments (p = 0.01) and BC-related emergency room visits (p = 0.03). Additionally, comorbidities were associated with non-BC-related utilization (p < 0.01), and nonwhites were more likely to utilize nonroutine resources, both BC and non-BC-related (p < 0.01). CONCLUSIONS Increased FCR has been associated with hypervigilance among survivors and may lead to increased healthcare utilization. YS are at higher risk for increased FCR and psychosocial concerns, which may lead to overutilization. Providers should be aware that higher FCR may be related to increased use of healthcare resources and that these patients might be better served with supportive resources to increase quality of life and decrease inappropriate utilization. While this study provides increased evidence of the relationship between FCR and healthcare utilization, interventions are needed for survivors at risk to address unmet needs, especially as life expectancy increases among BCS.
Collapse
Affiliation(s)
- Eric Vachon
- School of Nursing, Indiana University, Indianapolis, Indiana, USA
| | - Ellen Krueger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | | | - David A Haggstrom
- School of Medicine, Indiana University, Indianapolis, Indiana, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
| | - Andrea A Cohee
- School of Nursing, Indiana University, Indianapolis, Indiana, USA
| |
Collapse
|
|
45
|
Borstelmann NA, Rosenberg S, Gelber S, Zheng Y, Meyer M, Ruddy KJ, Schapira L, Come S, Borges V, Cadet T, Maramaldi P, Partridge AH. Partners of young breast cancer survivors: a cross-sectional evaluation of psychosocial concerns, coping, and mental health. J Psychosoc Oncol 2020; 38:670-686. [PMID: 33000705 DOI: 10.1080/07347332.2020.1823546] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Evaluation of psychosocial concerns, coping style, and mental health in partners of young (diagnosed at ≤40 years) survivors of early-stage breast cancer (BC). DESIGN Cross-sectional; partners participated in a one-time survey. SAMPLE 289 participants; most were male, white, working full-time, college educated, with median age of 43 years, parenting children <18 years old. METHODS Logistic regression was used to explore associations with anxiety and depression (≥8 on Hospital Anxiety and Depression sub-scales). FINDINGS Overall, 41% reported symptoms of anxiety, 18% reported symptoms of depression, and 44% identified maladaptive coping. Multivariable regression analyses revealed: lower social support and poorer quality of life significantly associated with depression (p < .05); maladaptive coping, fulltime employment, poorer caregiver QOL, and less education significantly associated with anxiety. CONCLUSIONS Partners of young BC survivors who use more maladaptive coping strategies, report less social support, work fulltime, and/or who have lower education levels experience negative mental health outcomes. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Enhancing constructive coping and ensuring all partners have access to supportive resources may improve partners' emotional adjustment.
Collapse
Affiliation(s)
| | - Shoshana Rosenberg
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Shari Gelber
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Yue Zheng
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Meghan Meyer
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Lidia Schapira
- Stanford University Medical Center, Stanford, California, USA
| | - Steven Come
- Harvard Medical School, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Tamara Cadet
- Simmons College School of Social Work, Boston, Massachusetts, USA
| | - Peter Maramaldi
- Simmons College School of Social Work, Boston, Massachusetts, USA.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
|
46
|
Hu X, Wang W, Wang Y, Liu K. Fear of cancer recurrence in patients with multiple myeloma: Prevalence and predictors based on a family model analysis. Psychooncology 2020; 30:176-184. [PMID: 32931646 PMCID: PMC7984278 DOI: 10.1002/pon.5546] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/11/2020] [Accepted: 08/31/2020] [Indexed: 11/18/2022]
Abstract
Objective Fear of cancer recurrence (FCR) is a common psychosocial sequela among cancer survivors, but data on patients with multiple myeloma are scarce. This study calculated the prevalence of FCR and identified family and social factors that predict FCR in the study population. Methods We recruited 127 myeloma patients and their partners to participate in a cross‐sectional survey from a regional tertiary cancer centre in China. The questionnaires included items on demographic characteristics and from the fear of disease progression simplified scale, family hardiness index and Social Support Scale. Univariate and multivariate regression was used to identify predictors of FCR. Results Of the participants, 56.4% patients reported high‐level FCR, which was similar to the partner‐reported proportion. The partners' FCR was positively associated with the patients' FCR, while family hardiness and social support were statistically significant, negative predictors. Conclusions Interventions to mitigate partners' FCR and improve family hardiness and social support may help with the psychological adjustment and well‐being of myeloma patients.
Collapse
Affiliation(s)
- Xiaochun Hu
- Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Weida Wang
- Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Ye Wang
- Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Ke Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China
| |
Collapse
|
|
47
|
McDonough AL, Lei Y, Kwak AH, Haggett DE, Jimenez RB, Johnston KT, Moy B, Spring LM, Peppercorn J. Implementation of a Brief Screening Tool to Identify Needs of Breast Cancer Survivors. Clin Breast Cancer 2020; 21:e88-e95. [PMID: 32807644 DOI: 10.1016/j.clbc.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/26/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Innovation in health care delivery is needed to improve care for cancer survivors. We report our experience with adapting screening questions from the National Comprehensive Cancer Network (NCCN) guideline to evaluate the needs of breast cancer survivors. MATERIALS AND METHODS We adapted the NCCN-recommended screening questions into a plain language, self-administered 1-page intake questionnaire. The tool was administered to a convenience sample of female breast cancer survivors at follow-up oncology and primary care visits. Domains included symptoms, lifestyle concerns, and financial issues. Frequency of concerns was assessed as "never," "rarely," "sometimes," "very frequently," and "always." We evaluated feasibility and utility of administration and the prevalence and frequency of patient-reported concerns. RESULTS The questionnaire was highly acceptable to patients and enhanced visits for clinicians. Clinicians reported that it led to discussion of issues that may not otherwise be addressed in the visit and did not find it burdensome. The most commonly endorsed patient concerns were desire to improve fitness or nutrition, worry about cancer recurrence, and insomnia. A majority also reported feeling anxiety and aches or pains in joints or extremities. Several issues known to be underreported in clinic visits were frequently endorsed, included sexual dissatisfaction and memory impairments. Clinicians suggested incorporating the tool into the electronic health record to increase utility and awareness. CONCLUSION Screening for individual needs among breast cancer survivors is feasible, efficient, and may identify prevalent issues that otherwise can be missed in routine survivorship care.
Collapse
Affiliation(s)
| | - Yvonne Lei
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Agnes H Kwak
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Dana E Haggett
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Rachel B Jimenez
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Beverly Moy
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Laura M Spring
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | |
Collapse
|
|
48
|
Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, Rutkowski N, Ta V, Trudel G, Laflamme SZ, Lavigne AA, Dinkel A. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One 2020; 15:e0234124. [PMID: 32716932 PMCID: PMC7384626 DOI: 10.1371/journal.pone.0234124] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses. METHODS We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained. RESULTS There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features. CONCLUSIONS The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
Collapse
Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Christina Tomei
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Georden Jones
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicole Rutkowski
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Ta
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Trudel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
|
49
|
An Integrative Review on Factors Contributing to Fear of Cancer Recurrence Among Young Adult Breast Cancer Survivors. Cancer Nurs 2020; 45:E10-E26. [DOI: 10.1097/ncc.0000000000000858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
|
50
|
Martin CM, Greene D, Harrell JP, Mwendwa DT, Williams CD, Horton S, Cradle M, Hudson BD, Taylor TR. The impact of social constraints on insomnia among African-American breast cancer survivors: The mediating role of fear of recurrence. Psychooncology 2020; 29:1296-1302. [PMID: 32458549 DOI: 10.1002/pon.5435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/25/2020] [Accepted: 05/05/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Insomnia is a significant concern among African-American breast cancer survivors (BCS). Social constraints (SC)-receiving unsupportive or critical responses when expressing trauma-related emotions-and fear of recurrence (FOR) have been associated with insomnia. We examined FOR as a mediator in the relationship between SC and insomnia in African-American BCS. We hypothesized a direct effect of SC on insomnia, and an indirect effect of SC on insomnia through FOR. METHODS Sixty-four African-American BCS completed a questionnaire assessing demographics, clinical characteristics, SC, FOR, and insomnia. Participants were an average of M = 8.41 (SD = 5.8) year survivors. The mediation was tested using PROCESS for SPSS. RESULTS The direct effect of SC on insomnia was significant (direct effect = .17, SE = .08, P = .04). Moreover, the indirect effect of SC on insomnia through FOR was significant (indirect effect = .19, SE = .10, 95% CI = .05, .41). CONCLUSIONS Experiencing SC from family and friends could produce cognitions that impact sleep for BCS, and FOR could be one of those cognitions. Family-based models of care that emphasize the emotional needs of survivors and families could be a relevant strategy to address the SC that impacts sleep.
Collapse
Affiliation(s)
- Chloé M Martin
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Danyella Greene
- Department of Psychology, Howard University, Washington, DC, USA.,College of Medicine, Howard University, Washington, DC, USA
| | - Jules P Harrell
- Department of Psychology, Howard University, Washington, DC, USA
| | | | | | - Sara Horton
- College of Medicine, Howard University, Washington, DC, USA
| | - Melanie Cradle
- Health Careers Opportunity Program, Howard University, Washington, DC, USA
| | - Briana D Hudson
- Health Careers Opportunity Program, Howard University, Washington, DC, USA
| | | |
Collapse
|