The intrapersonal and interpersonal processes of fear of recurrence among cervical cancer survivors: a qualitative study

The Experience of Cervical Cancer Patients Undergoing Hysterectomy: A Qualitative Study

INTRODUCTION

Due to different social and cultural backgrounds, cervical cancer patients' experience of the treatment process and quality of life after treatment will be different. This study sought to gain in-depth understanding of the experiences of Chinese cervical cancer patients as regards their quality of life and physical symptoms.

METHODOLOGY

Semi-structured interviews were used to collect data. We recruited 15 women with cervical cancer in eastern China for in-depth interviews. All data were entered into the NVivo 12 software program for analysis.

RESULTS

Four themes emerged from the data: (a) uncertainty; (b) physical suffering; (c) psychological pressure; and (d) challenges of marriage and family.

DISCUSSION

Cervical cancer patients showed concerns about the disease itself and the physical discomfort it causes, as well as changes in social relations. Health professionals need to talk about these issues and develop strategies to address them accordingly.

Cognitive behavioral stress management is an effective intervention to relieve anxiety and depression, improve the quality of life in patients with cervical cancer

BACKGROUND

Cognitive behavioral stress management (CBSM) modifies individuals' maladaptive cognition and improves their ability in managing stress. The present study was to inquire about the utility of CBSM in mental health and quality of life in patients with cervical cancer.

METHODS

Totally, 172 postoperative cervical cancer patients were randomly classified into CBSM (N=86) and normal care group (N=86) to receive 8-week CBSM and normal care, correspondingly. Self-rating anxiety/depression scale (SAS/SDS), EuroQol-5 dimensions (EQ-5D), EuroQol-visual analogue scale (EQ-VAS), and quality of life questionnaire-core 30 (QLQ-C30) scores were evaluated at discharge (M0), 1st month (M1), M3, and M6 after discharge.

RESULTS

SAS scores at M6 (P=0.003), M1 (P=0.042), and M3 (P=0.010), and the proportion of patients with SAS-defined anxiety at M3 (P=0.040) and M6 (P=0.019) were reduced in CBSM group versus normal care group. SDS scores at M3 (P=0.020) and M6 (P=0.016), and the proportion of patients with SDS-defined depression at M6 (P=0.036) was descended in CBSM group versus normal care group. EQ-VAS score at M1 (P=0.044), M3 (P=0.014), and M6 (P=0.002) were increased, while EQ-5D score at M3 (P=0.030) was descended in CBSM group versus normal care group. Meanwhile, QLQ-C30 global health status score at M1 (P=0.046), M3 (P=0.037), and M6 (P=0.007), QLQ-C30 function score at M3 (P=0.033) and M6 (P=0.016) were ascended, but QLQ-C30 symptom score at M3 (P=0.042) was declined in CBSM group versus normal care group.

CONCLUSION

CBSM is an effective intervention for decreasing anxiety and depression, and improving quality of life in patients with cervical cancer.

A latent class analysis of family resilience and its relationship with fear of recurrence in lung cancer patients: a cross-sectional study

PURPOSE

Family resilience helps cancer-affected families overcome challenges and may influence an individual's fear of cancer recurrence (FCR). Identifying distinct classes of family resilience among lung cancer patients is crucial for tailored interventions. This study aimed to identify latent classes of family resilience in lung cancer patients and explore their relationships with FCR.

METHODS

Three hundred ten lung cancer patients from three hospitals in Fujian were recruited from June to September 2021. Clinical data were extracted from medical records, while sociodemographic details, family resilience, and FCR were self-reported. A latent class analysis was performed to identify family resilience classes.

RESULTS

A 4-class solution showed the best fit. Compared to Class 1, the patients who had no comorbidities (ORs = 3.480-16.005) had an increased likelihood of belonging to Class 2 and 3, while those who were not family breadwinners (ORs = 0.118-0.176) had a decreased likelihood. Further, the patients who (1) did not lack interest/pleasure in doing things during the past 2-week period (OR = 7.057), (2) were never smokers (OR = 6.230), and (3) were urban residents (OR = 8.985) had an increased likelihood of belonging to Class 4, while those who were (1) male (OR = 0.167), (2) not the family breadwinner (OR = 0.152), and (3) had none or only one child (OR = 0.203) had a decreased likelihood of belonging to Class 4. The FCR level differed significantly among these four classes.

CONCLUSION

Our study identified four distinct classes of family resilience among Chinese lung cancer patients. FCR severity decreased with increasing levels of family resilience.

Ethical challenges as perceived by nurses in pediatric oncology units

BACKGROUND

Providing care to children with cancer is one of the most challenging areas of ethical care for nurses. Few studies have addressed nurses' perception of the barriers to giving ethical care in oncology departments. Thus, it is essential that the ethical challenges in caregiving as perceived by oncology nurses be investigated.

OBJECTIVE

The present study was conducted to investigate the ethical challenges as perceived by nurses in pediatric oncology units in the south of Iran.

RESEARCH DESIGN

The present study is a qualitative work of research with a conventional content analysis design. Data were collected via individual semi-structured interviews. The collected data were analyzed using the qualitative content analysis method.

PARTICIPANTS AND RESEARCH CONTEXT

The participants were 21 nurses from pediatric oncology units in state hospitals who were selected by purposeful sampling. Sampling continued until the data were saturated. The study lasted from April to October 2022.

FINDINGS

Three main themes, promoting psychological safety in the children, respect for the dignity of the children, and expansion of support for families, and nine subthemes were extracted from the data.

ETHICAL CONSIDERATIONS

The study's protocol was approved by the Research Ethics Committee of the University of Medical Sciences and ethical principles were followed throughout the study.

DISCUSSION AND CONCLUSION

From the nurses' perspective, the major ethical challenges in providing ethical care in pediatric oncology units were reducing tension toward promoting the patients' psychological safety, showing respect for the identity and dignity of the children with cancer, and expanding support of the patients' families. By creating the right cultural and professional context and establishing proper protocols, healthcare policymakers and administrators can take effective steps toward eliminating the barriers to providing ethical care.

Familial aspects of fear of cancer recurrence: current insights and knowledge gaps

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.

Social Support and Fear of Cancer Recurrence Among Chinese Breast Cancer Survivors: The Mediation Role of Illness Uncertainty

Objective

To examine the relations between social support, illness uncertainty (IU), and fear of cancer recurrence (FCR).

Methods

Using data from a convenience sample of 231 breast cancer survivors in China to perform structural equation modeling with bootstrapping estimation. Participants were recruited from a general hospital in Shenyang, China. Participants completed the Perceived Social Support Scale, Mishel Uncertainty in Illness Scale, and Fear of Cancer Recurrence Inventory- Shorter Form.

Results

The majority of breast cancer survivors have FCR (67.5%). FCR was significantly negatively associated with social support, and was significantly positively associated with IU (both P < 0.01). Moreover, IU was found to mediate the relationship between social support and FCR (standardized indirect effect = -0.18; bias-corrected 95% confidence interval: -0.255, -0.123).

Conclusion

The findings support the final model. Good social support can directly mitigate FCR, while illness uncertainty can play a mediation role between social support and FCR. Further studies should be conducted to explore effective interventions for social support and IU to ultimately mitigate FCR in cancer survivors.