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Jrad AIS, Yi Y, Yoon B, Cho E, Cho IK, Lee D, Kim J, Chung S, Kim JH. Dysfunctional Self-Focus and Fear of Progression in Cancer Patients Mediated by Depression, Anxiety, and Dysfunctional Sleep Beliefs. Psychiatry Investig 2024; 21:506-512. [PMID: 38810999 PMCID: PMC11136582 DOI: 10.30773/pi.2023.0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/08/2024] [Accepted: 02/19/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE This study explores whether cancer patients' dysfunctional self-focus is a significant contributor to their fear of progression. In addition, we investigated whether their psychiatric symptoms such as depression, anxiety, and dysfunctional beliefs about sleep may mediate the relationship between these factors. METHODS We conducted a retrospective medical records review of 196 cancer patients who visited the Stress Management Clinic for the first time from March to September 2022. Their demographic information and responses to rating scales such as the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Dysfunctional Self-focus Attribution Scale (DSAS), Patient Health Questionnaire-9 Items (PHQ-9), State subcategory of the State and Trait of Anxiety Inventory (STAI-S), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep scale (C-DBS), and numeric rating scales of pain and fatigue were collected. RESULTS A high FoP-Q-SF score was significantly correlated with high PHQ-9 (r=0.60), STAI-S (r=0.38), ISI (r=0.34), C-DBS (r=0.47), pain (r=0.24), fatigue (r=0.37), and DSAS (r=0.58, all p<0.001). A linear regression analysis showed that the FoP-Q-SF score was significantly predicted by younger age (β=-0.13, p=0.011), PHQ-9 (β=0.36, p<0.001), STAI-S (β=0.18, p=0.001), C-DBS (β=0.22, p<0.001), and DSAS (β=0.25, p<0.001). A mediation analysis showed that dysfunctional self-focus directly influenced patients' fear of progression. In addition, cancer patients' depression, anxiety, and cancer-related dysfunctional beliefs about sleep mediated this relationship. CONCLUSION We observed that dysfunctional self-focus may influence cancer patients' fear of progression, mediated by depression, anxiety, and cancer-related dysfunctional beliefs about sleep.
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Affiliation(s)
| | - Youngseok Yi
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byeongha Yoon
- University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Inn-Kyu Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dongin Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiyoung Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong Hye Kim
- Department of Clinical Nursing, University of Ulsan, Seoul, Republic of Korea
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Büyükokudan Ş, Korukcu O. Fear of Cancer and State Anxiety Among Women Undergoing Hysterectomy: A Cross-sectional Study. Cancer Nurs 2024:00002820-990000000-00243. [PMID: 38625784 DOI: 10.1097/ncc.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
BACKGROUND Fear of cancer may develop after surgery in women who underwent surgery for suspected malignancy in preoperative examinations. It is important from a psychosocial point of view that the fear of cancer and the factors affecting anxiety are determined and necessary interventions are made. OBJECTIVES The aim of this study was to determine the level of state anxiety, fear of cancer, and influencing factors in women who had hysterectomies with a risk of cancer in the waiting period for the pathology result. METHODS The research data were collected from 109 women who underwent hysterectomy while waiting for the pathology result on the third or fourth postoperative day. Patients completed the Personal Information Form, State-Trait Anxiety Inventory-I, and Cancer Worry Scale. RESULTS Women who underwent hysterectomy with the risk of gynecological cancer had high levels of state anxiety and cancer fear after hysterectomy; type of hysterectomy significantly affected cancer fear (P = .022), and social support (P = .015), type of hysterectomy (P = .024), and family history of cancer (P = .022) significantly affected state anxiety. CONCLUSION The management of these women's concerns can be improved if healthcare professionals know more about the factors affecting their state anxiety and fear. IMPLICATIONS FOR PRACTICE Health professionals witness patients' most private experiences and play a key role in providing care and support. This study may be foundational in the planning and implementation of nursing interventions to manage causes of anxiety and fear during this waiting period.
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Affiliation(s)
- Şerife Büyükokudan
- Authors' Affiliation: Department of Obstetrics and Gynaecological Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Liu P, Wu Q, Cheng Y, Zhuo Y, Li Z, Ye Q, Yang Q. Associations of illness perception and social support with fear of progression in young and middle-aged adults with digestive system cancer: A cross-sectional study. Eur J Oncol Nurs 2024; 70:102586. [PMID: 38657348 DOI: 10.1016/j.ejon.2024.102586] [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: 01/17/2024] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE While Fear of progression (FoP) is a natural reaction in cancer, elevated FoP can impact life quality and social function. Our study aims to explore how illness perception, social support, and posttraumatic growth influence patients' FoP. METHODS This study enrolled 243 young and middle-aged adults with digestive system cancer at a hospital in Guangzhou from November 2022 to November 2023. In this study, the measurement instruments utilized included The Fear of Progression Questionnaire-Short Form, The Brief Illness Perception Questionnaire, The 12-item Perceived Social Support Scale, and The 21-item Posttraumatic Growth Inventory. Data was analyzed employing polynomial regression and response surface analyses. RESULTS The mean score of FoP was 35.45 ± 10.05, and 59.3% of the cancers (scores≥34) had clinically dysfunctional levels of FoP. Regarding congruence, patients' FoP was higher when the levels of illness perception and social support were both low or high than when the levels were both intermediate. Regarding incongruence, patients' FoP was lower when the level of illness perception was low and social support was high compared with when the level of illness perception was high and social support was low. Additionally, posttraumatic growth moderated the (in)congruence effect of illness perception-social support on the FoP of patients. CONCLUSIONS Low or high illness perception-social support congruence was detrimental to the FoP of patients. Low illness perception-high social support incongruence was beneficial to patients' FoP. Posttraumatic growth can be a positive factor for enhancing the impact of low illness perception-high social support incongruence on patients' FoP.
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Affiliation(s)
- Peng Liu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qinyang Wu
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yingying Cheng
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Yishang Zhuo
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Zihan Li
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qiuyun Ye
- Tianhe Shipai Huashi Community Health Service Center, Guangdong, China.
| | - Qiaohong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, China.
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Ren H, Yang T, Yin X, Tong L, Shi J, Yang J, Zhu Z, Li H. Prediction of high-level fear of cancer recurrence in breast cancer survivors: An integrative approach utilizing random forest algorithm and visual nomogram. Eur J Oncol Nurs 2024; 70:102579. [PMID: 38636114 DOI: 10.1016/j.ejon.2024.102579] [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: 08/17/2023] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE This study is the first attempt to use a combination of regression analysis and random forest algorithm to predict the risk factors for high-level fear of cancer recurrence and develop a predictive nomogram to guide clinicians and nurses in identifying high-risk populations for high-level fear of cancer recurrence. METHODS After receiving various recruitment strategies, a total of 781 survivors who had undergone breast cancer resection within 5 years in four Grade-A hospitals in China were included. Besides demographic and clinical characteristics, variables were also selected from the perspectives of somatic, cognitive, psychological, social and economic factors, all of which were measured using a scale with high reliability and validity. This study established univariate regression analysis and random forest model to screen for risk factors for high-level fear of cancer recurrence. Based on the results of the multi-variable regression model, a nomogram was constructed to visualize risk prediction. RESULTS Fatigue, social constraints, maladaptive cognitive emotion regulation strategies, meta-cognition and age were identified as risk factors. Based on the predictive model, a nomogram was constructed, and the area under the curve was 0.949, indicating strong discrimination and calibration. CONCLUSIONS The integration of two models enhances the credibility of the prediction outcomes. The nomogram effectively transformed intricate regression equations into a visual representation, enhancing the readability and accessibility of the prediction model's results. It aids clinicians and nurses in swiftly and precisely identifying high-risk individuals for high-level fear of cancer recurrence, enabling the development of timely, predictable, and personalized intervention programs for high-risk patients.
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Affiliation(s)
- Hui Ren
- Nursing Department, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Tianye Yang
- Department of Plastic Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Xin Yin
- Nursing Department, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Lingling Tong
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Jianjun Shi
- Department of Breast Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province, China.
| | - Jia Yang
- Changchun Central Hospital, Changchun, Jilin Province, China.
| | - Zhu Zhu
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Hongyan Li
- The First Hospital of Jilin University, Changchun, Jilin Province, China.
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Zhang Y, Liu S, Miao Q, Zhang X, Wei H, Feng S, Li X. The Heterogeneity of Symptom Burden and Fear of Progression Among Kidney Transplant Recipients: A Latent Class Analysis. Psychol Res Behav Manag 2024; 17:1205-1219. [PMID: 38524288 PMCID: PMC10959014 DOI: 10.2147/prbm.s454787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose Kidney transplant recipients (KTRs) may experience symptoms that increase their fear of progression (FoP), but a dearth of research examines the issue from a patient-centered perspective. Our study aimed to first determine the category of symptom burden, then to explore the differences in characteristics of patients in different subgroups, and finally to analyze the impact of symptom subgroup on FoP. Patients and Methods Sociodemographic and Clinical Characteristics, Symptom Experience Scale, and Fear of Progression Questionnaire-Short Form were used. Latent class analysis was used to group KTRs according to the occurrence of symptoms. We used multivariate logistic regression to analyze the predictors of different subgroups. The differences in FoP among symptom burden subgroups were analyzed by hierarchical multiple regression. Results Three subgroups were identified, designated all-high (20.5%), moderate (39.9%), and all-low (39.6%) according to their symptom occurrence. Multivariate logistic regression showed that gender, post-transplant time, per capita monthly income, and hyperuricemia were the factors that distinguished and predicted the all-high subgroup (P < 0.05). Hierarchical multiple regression showed that symptom burden had a significant effect on FoP (class1 vs class3: β = 0.327, P < 0.001; class2 vs class3: β = 0.104, P = 0.046), explaining the 8.0% variance of FoP (ΔR2 = 0.080). Conclusion KTRs generally experience moderate or low symptom burden, and symptom burden is an influencing factor in FoP. Identifying the traits of KTRs with high symptom burden can help clinicians develop targeted management strategies and ease FoP of KTRs.
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Affiliation(s)
- Ying Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Sainan Liu
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Qi Miao
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xu Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - He Wei
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Shuang Feng
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xiaofei Li
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
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van der Ende-van Loon MCM, Oude Nijhuis RAB, Curvers WL, Schoon EJ. Prevalence and associated factors of worry for cancer in patients with a Barrett's esophagus. Sci Rep 2024; 14:2878. [PMID: 38311635 PMCID: PMC10838905 DOI: 10.1038/s41598-024-53428-y] [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: 06/15/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
Although the risk of cancer progression in a Barrett's esophagus (BE) is very low, worrying about cancer is known as an important factor affecting HRQoL. The aim of this study was to determine the proportion of BE patients with high levels of worry for cancer, to compare outcomes of patients endoscopically treated for BE neoplasia (DBE), non-dysplastic BE patients (NDBE) and patients with reflux symptoms, and to examine associated factors. We performed a cross sectional, exploratory, self-administered questionnaire study using the cancer worry scale, and the reflux disease questionnaire. A total of 192 DBE patients, 213 NDBE patients and 111 refractory reflux symptom patients were included from October 2019 until July 2021, 76.8% of BE participants were male and aged 66.9 years. High cancer worry was reported in 40.6% of the DBE patients and 36.2% of NDBE patient. Reflux patients scored statistically significant worse with 56.6% stated high cancer worry. Positive correlations were found between reflux symptoms and cancer worry in NDBE patients and reflux patients. In DBE patients' negative correlations were found between higher cancer worry and younger age as well as a family history of esophageal carcinoma. A clinically significant group of BE patients reported high cancer worry, which was associated with reflux symptoms in NDBE patients and a younger age and a (family) history of esophageal carcinoma diagnosis in BE patients treated for (early) neoplasia. Physicians should communicate about the actual cancer risk, which leads to greater patient understanding and therefore may have a positive impact on health outcomes.
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Affiliation(s)
- M C M van der Ende-van Loon
- Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
- GROW: School for Oncology and Developmental Biology, Maastricht UMC, Maastricht, The Netherlands.
| | - R A B Oude Nijhuis
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands
| | - W L Curvers
- Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - E J Schoon
- Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
- GROW: School for Oncology and Developmental Biology, Maastricht UMC, Maastricht, The Netherlands
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Lu Q, Liu Q, Fang S, Ma Y, Zhang B, Li H, Song L. Relationship between fear of progression and symptom burden, disease factors and social/family factors in patients with stage-IV breast cancer in Shandong, China. Cancer Med 2024; 13:e6749. [PMID: 38457242 PMCID: PMC10923048 DOI: 10.1002/cam4.6749] [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: 11/23/2022] [Revised: 09/13/2023] [Accepted: 09/30/2023] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE To assess fear of progression (FoP)'s relationship with symptom burden and disease and social/family factors, as well as, determine the status of FoP in women with stage-IV breast cancer in Shandong, China. METHODS Two hundred and sixteen women were recruited from the department of breast cancer internal medicine, Shandong Cancer Hospital and Institute. Data for this observational study were collected between October 2020 and January 2021 using the MD Anderson Symptom Inventory, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and a participant information scale. SPSS 23.0 was used for statistical analysis. RESULTS After excluding invalid responses, the data of 200 participants were analysed. The average total FoP-Q-SF score was 29.39 ± 9.39 (95% confidence interval, 21.81-27.64). The FoP level among the participants was relatively low. For disease and social/family factors, FoP statistically significantly differed by satisfaction with family emotional support and the Eastern Cooperative Oncology Group (ECOG) score. The ECOG score was positively correlated with FoP. Furthermore, symptom burden was positively correlated with FoP. CONCLUSIONS Among patients with stage-IV breast cancer, satisfaction with family emotional support, ECOG score and symptom burden play key roles in FoP. Interventions, including providing appropriate emotional support from family, improving physical fitness and relieving symptom burden, must be considered in future studies, which may improve patients' overall physical and mental status and provide a supportive therapeutic environment.
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Affiliation(s)
- Qianrun Lu
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Qiuyue Liu
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Shu Fang
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Yujin Ma
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Baoxuan Zhang
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Huihui Li
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
| | - Lihua Song
- Department of Breast Cancer Internal MedicineShandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical SciencesJinanChina
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Su CH, Liu Y, Hsu HT, Kao CC. Cancer Fear, Emotion Regulation, and Emotional Distress in Patients With Newly Diagnosed Lung Cancer. Cancer Nurs 2024; 47:56-63. [PMID: 35984922 DOI: 10.1097/ncc.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research related to newly diagnosed lung cancer patients' emotional regulation strategies and how these strategies influence their emotional distress is scarce. OBJECTIVE The aim of this study was to investigate the relationship between cancer fear, emotion regulation, and emotional distress in patients with newly diagnosed lung cancer. METHOD A cross-sectional, correlation research design was conducted, using self-report questionnaires: the Cancer Fear Scale, the Emotion Regulation Questionnaire, and the Hospital Anxiety and Depression Scale. A total of 117 newly diagnosed lung cancer patients were sampled. RESULTS Nearly 70% of newly diagnosed lung cancer patients had a high level of cancer fear; 56.4%, depression; and 45.3%, anxiety. Depression was positively associated with cancer fear ( r = 0.239, P < .01) and expressive suppression ( r = 0.185, P < .05), but negatively associated with cognitive reappraisal ( r = -0.323, P < .01). Anxiety was positively associated with cancer fear ( r = 0.488, P < .01) but negatively associated with cognitive reappraisal ( r = -0.214, P < .05). Cancer fear and cognitive reappraisal were significant explanatory factors and explained 25.2% of variance in anxiety. Cancer fear, expressive suppression, and cognitive reappraisal were significant explanatory factors and explained 16.7% of variance in depression. CONCLUSIONS Newly diagnosed lung cancer patients with cancer fear and who used fewer cognitive reappraisal strategies or more expressive suppression had more emotional distress. IMPLICATIONS FOR PRACTICE Clinicians should be attentive to patients' cancer fears and emotion regulation strategies as early as possible to prevent their emotional distress.
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Affiliation(s)
- Chia-Huei Su
- Author Affiliations: Department of Nursing (Ms Su and Dr Hsu) and Department of Medical Research (Dr Liu and Dr Hsu), Kaohsiung Medical University Hospital, Kaohsiung Medical University; College of Nursing (Dr Liu) and School of Nursing (Dr Hsu), Kaohsiung Medical University; and Department of Nursing, I-Shou University (Dr Kao), Kaohsiung, Taiwan, ROC
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Chen F, Ou M, Xiao Z, Xu X. Trajectories of fear of cancer recurrence and its influence factors: A longitudinal study on Chinese newly diagnosed cancer patients. Psychooncology 2024; 33:e6271. [PMID: 38282228 DOI: 10.1002/pon.6271] [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: 04/10/2023] [Revised: 10/21/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The fear of cancer recurrence (FCR) is an ongoing and common psychological problem faced by cancer patients. The objective of this study was to explore the variation trend of FCR and its influencing factors in Chinese newly diagnosed cancer patients from admission to 2 months after discharge. Demographic and tumor characteristics, as well as experiential avoidance (EA), were used as predictors. METHOD A longitudinal design and a consecutive sampling method were used to select 266 newly diagnosed cancer patients admitted to a tertiary cancer hospital in China from July to December 2022. Measurements of FCR and EA were obtained at admission (T1), 1 month after discharge (T2), and 2 months post-discharge (T3). Generalized estimating equations were used to identify factors associated with FCR for longitudinal data analysis. RESULTS A total of 266 participants completed the follow-up. Both FCR and EA scores of patients with newly diagnosed cancer showed a significant trend of first increasing and then decreasing at baseline and follow-up (p < 0.001). The junior secondary and less education level, rural residence, advanced tumor and high EA level were risk factors for higher FCR. CONCLUSIONS Our findings suggest that the FCR levels of most newly diagnosed cancer patients in China are different at the three time points and affected by different factors, with the highest level at 1 month after discharge. These results have significant implications for future identifying populations in need of targeted intervention based on their FCR trajectories.
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Affiliation(s)
- Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
| | - Zhirui Xiao
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
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Ma S, Yang X, Xiang S, Lu G, Gong W, Chen W. Psychometric validation of the fear of progression questionnaire-short form in acute pancreatitis patients. Heliyon 2023; 9:e19060. [PMID: 37654456 PMCID: PMC10465851 DOI: 10.1016/j.heliyon.2023.e19060] [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: 01/20/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Fear of progression (FoP) is associated with the quality of life and behavioral change in acute pancreatitis (AP) patients, but lack of assessment tools. Aim This study aimed to develop and evaluate the psychometric properties of the Fear of Progression Questionnaire-Short Form in AP patients (AP-FoP-Q-SF). Methods Internal consistency, factorial structure, convergent validity, and criterion validity of AP-FoP-Q-SF were assessed. A receiver operating characteristic (ROC) curve analysis was performed to identify the cutoff value for high FoP. Associations between patient variables and FoP were evaluated using multiple logistic regression. Wilcox rank sum test was used to analyses the costs and length of hospital stay of the patients with high FoP. Results The two-factor structure showed a good fit. Internal consistency was acceptable (Cronbach's α = 0.771). The cutoff of 26 identified 35.3% of patients with high FoP. High FoP scores were associated with age (OR = 0.96, 95%CI: 0.94-0.98), recurrence times (OR = 1.22, 95%CI: 1.02-1.45) and anxiety (OR = 1.27, 95%CI: 1.16-1.40). Patients with high FoP spent more cost and time in the hospital. Conclusions The AP-FoP-Q-SF is a good FoP tool for AP patients in China. Implications for practice Clinicians can use the AP-FoP-Q-SF to assess FoP and take promotion programs to avoid worse effects.
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Affiliation(s)
- Shuli Ma
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, China
- Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, China
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiaoxi Yang
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, China
- School of Nursing, Yangzhou University, Yangzhou, China
| | | | - Guotao Lu
- Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Weiwei Chen
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, China
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Park SK, Min YH. Fear of cancer recurrence in South Korean survivors of breast cancer who have received adjuvant endocrine therapy: a cross-sectional study. Front Psychol 2023; 14:1170077. [PMID: 37575431 PMCID: PMC10414191 DOI: 10.3389/fpsyg.2023.1170077] [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: 02/27/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Fear of cancer recurrence (FCR) is one of the most-prevalent psychological problems among cancer survivors, and younger females who have received endocrine therapy are particularly at risk of high FCR. The aim of this study was to determine the relationship between high FCR and factors related to it in South Korean patients with breast cancer who receive adjuvant endocrine therapy (AET). Methods This cross-sectional study recruited 326 patients with breast cancer who had received AET. All participants were asked to complete a personal information sheet, the short form of the Fear of Progression Questionnaire, and the Menopause Rating Scale. The factors associated with high FCR were analyzed using association-rule analysis. Results The mean FCR score was 32.24 (SD = 10.22), and 137 of the 326 (42.0%) patients had high scores (≥34). Hot flushes and sweating (moderate to extremely severe), depressed mood (moderate to extremely severe), irritability (moderate to extremely severe), invasive stage, taking tamoxifen, and being married were associated with high FCR. Conclusion Since FCR was common in patients with breast cancer who received AET, patients at a greater risk of experiencing FCR must be screened and supported.
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Affiliation(s)
- Seul Ki Park
- Department of Nursing, Daejeon University, Daejeon, Republic of Korea
| | - Yul Ha Min
- College of Nursing, Kangwon National University, Kangwon-do, Republic of Korea
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Chen R, Yang H, Zhang H, Chen J, Liu S, Wei L. Fear of progression among postoperative patients with newly diagnosed lung cancer: a cross-sectional survey in China. BMC Psychol 2023; 11:168. [PMID: 37217966 DOI: 10.1186/s40359-023-01211-5] [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: 11/02/2022] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients. OBJECTIVE To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection. METHODS A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP. RESULTS The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18-39 years) than middle-aged patients (40-59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40-59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18-39 years and 40-59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients' age, the time from surgery and SSRS score were found to be independently associated with higher FoP. CONCLUSIONS High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.
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Affiliation(s)
- Ruiyun Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Hui Yang
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China.
| | - Hongmei Zhang
- Department of Nursing, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, Henan, People's Republic of China
| | - Jingru Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Saisai Liu
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Li Wei
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
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Yang Y, Qi H, Li W, Liu T, Xu W, Zhao S, Yang F, Humphris G, Chen Y, Sun H. Predictors and trajectories of fear of cancer recurrence in Chinese breast cancer patients. J Psychosom Res 2023; 166:111177. [PMID: 36739729 DOI: 10.1016/j.jpsychores.2023.111177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/06/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer patients. This study explored the trajectories of FCR over the 18 months following discharge, and evaluated the associations between baseline demographic and clinical variables and FCR trajectories among Chinese women treated for breast cancer. METHODS This is a longitudinal prospective study. All participants were asked to completed a battery of questionnaires (FCR-7, PHQ-9, GAD-7 and MPQ-VAS) at baseline, 6, 12, and 18 months after discharge. Generalized linear mixed model and group-based trajectory analyses were conducted. RESULTS Three hundred women with breast cancer were recruited. Latent class growth modeling analysis showed that three-group trajectory solution was the best fitting (i.e., 'intermediate level-stable group' (63.3%), 'low level-increasing group' (18.3%), and 'high level-decreasing group' (18.3%). Patients reported significant higher FCR at baseline assessment compared to other time points. Significant positive associations were found between anxiety, depression and FCR. Patients who had no baseline depression (estimate = -2.14, 95% CI: -2.78-(-1.51), P < 0.001) or anxiety (estimate = -2.77, 95% CI: -3.44-(-2.10), P < 0.001) tended to report significant lower FCRs over time. Women with none/mild life stress exhibited significant lower FCRs than those with moderate/high life stress, and participants with a family history of cancer or pessimism reported higher FCRs. CONCLUSION >60% of the breast cancer women showed intermediate level-stable FCRs over the 18 months after discharge. Baseline anxiety, depression, life stress, family cancer history and pessimism predicts higher FCR levels. Clinical teams responsible for continuing patient care following treatment should develop clearer strategies for management of FCR.
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Affiliation(s)
- Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Han Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100000, China
| | - Wengao Li
- Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou 510515, China
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou 510515, China
| | - Wenjing Xu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Shunzhen Zhao
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
| | - Fan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
| | - Gerry Humphris
- Division of Population and Behavioural Sciences, Medical School, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou 510515, China.
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
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Wang Y, Yu Q, Zeng Z, Yuan R, Wang R, Chen J, Zhou H, Tang J. Predictors of fear of diabetes progression: A multi-center cross-sectional study for patients self-management and healthcare professions education. Front Public Health 2022; 10:910145. [PMID: 36600932 PMCID: PMC9806215 DOI: 10.3389/fpubh.2022.910145] [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: 05/13/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Excessive fear of progression can affect the mental health, social function, and wellbeing of patients with chronic diseases. This study investigated the fear of progression (FoP) and the socio-demographic and clinical predictors among patients with type 2 diabetes mellitus (T2DM). Method The present study is a multi-center cross-sectional study. Inpatients with T2DM were recruited by a multi-stage convenience sampling method from the department of endocrinology in 5 tertiary hospitals in Southwest China. 459 T2DM patients were consecutively enrolled. Socio-demographic, clinical data, and answers to the fear of progression questionnaire (FoP-Q) were collected. Results 385 patients with complete data were eligible. The average score of FoP-Q-SF was 26.84 and 23.1% of patients reached the dysfunctional fear of progression criterion. The greatest fears were worrying about "disease progression," "the adverse reactions of medication," and "relying on strangers for activities of daily living." Health education (P < 0.001), age (P = 0.002), hypoglycemia history (P = 0.006), employment status (P = 0.025) and duration since being diagnosed with type 2 diabetes mellitus (P = 0.032) were the related factors of fear of progression. Conclusion Early assessment of the fear of progression was imperative to identify dysfunctional fear of progression in patients with type 2 diabetes mellitus. Meanwhile, the meaning of these predictors for strengthening healthcare professions education and patients self-management might help healthcare givers timely perform related interventions and help patients reduce their fear of progression thus actively cooperate with T2DM treatments.
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Affiliation(s)
- Yanhao Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China,Department of Orthodontics, School of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiuhua Yu
- Department of Breast Surgery, Peking Union Medical College Hospital (Xidan Campus), Beijing, China
| | - Zihuan Zeng
- State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China,Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ruizhu Yuan
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Ruiding Wang
- Department of Critical Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jianli Chen
- Guangzhou Women and Children Medical Center, Guangzhou Medical University Affiliated Women and Children Medical Center, Guangzhou, China
| | - Hengyu Zhou
- School of Nursing, Chongqing Medical University, Chongqing, China,*Correspondence: Hengyu Zhou
| | - Jiao Tang
- School of Nursing, Chongqing Medical University, Chongqing, China,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,Jiao Tang
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Li W, Zhang Q, Xu Y, Sun H, Wen Y, Xu W, Tong Y, Garg S, Chen Y, Yang Y. Group-based trajectory and predictors of anxiety and depression among Chinese breast cancer patients. Front Public Health 2022; 10:1002341. [PMID: 36299758 PMCID: PMC9589271 DOI: 10.3389/fpubh.2022.1002341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/21/2022] [Indexed: 01/27/2023] Open
Abstract
Background The aim of the current study is to investigate the change in anxiety and depression amongst Chinese breast cancer patients and to identify causal associations between baseline variables and the trajectory of anxiety and depression within this identified group. Methods This is a longitudinal prospective study. Three hundred women with breast cancer were recruited. Patient's depression and anxiety were repeatedly measured by PHQ-9 and GAD-7 at baseline, 6, 12, and 18 months after discharge. The SAS 9.4 PROC Traj procedure was used to examine the group-based trajectory of these recruited patients. Linear mixed models (LMM) were utilized to examine anxiety/depression changes over time, accounting for relevant baseline demographic and clinical factors. Results About 26.3% of the participants reported none or very mild anxiety over time, 60.7% reported stable low-level anxiety, and the remaining 13.0% showed significantly decreasing trend in GAD total scores. Meanwhile, 10.7% of the participants reported none or very mild depressive symptoms over time, 66.0% reported stable PHQ total scores throughout the research period, and 23.3% were classified as the "high level-decreasing group". Patients reported significantly higher anxiety and depression scores in the first three assessments. Participants with no or mild life stress along with a positive personality tended to report lower anxiety and depression scores over time. Conclusion Most of the breast cancer patients reported stable low-level anxiety and depression 18 months after discharge. Early assessment of optimism and stress levels among cancer patients might help identify people at risk of experiencing long-term anxiety and depression.
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Affiliation(s)
- Wengao Li
- Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Qiongxiao Zhang
- Department of Nursing, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Yining Xu
- Department of Nursing, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Youlu Wen
- Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Wenjing Xu
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yiling Tong
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China,Yu Chen
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China,*Correspondence: Yuan Yang
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Iglesias-Puzas Á, García-González V, Conde-Taboada A, López-Bran E. Fear of cancer recurrence in patients with non-metastatic melanoma: Spanish validation and disease-related factors. Australas J Dermatol 2022; 63:e312-e319. [PMID: 35904493 DOI: 10.1111/ajd.13907] [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: 05/27/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION It is essential for clinicians to understand the phenomenon of fear of cancer recurrence (FCR) in order to understand the psychological impact it has on patients with melanoma. OBJECTIVES To validate an FCR questionnaire in Spanish for patients with non-metastatic melanoma and to describe the clinical and demographic variables associated with FCR in these patients. METHODS Patients diagnosed with non-metastatic melanoma were selected. The questionnaire was translated and adapted to Spanish following international guidelines. The internal consistency, construct validity, and temporal stability of the questionnaire were analysed using Cronbach's alpha, confirmatory factor analysis, and test-retest reliability, respectively. Following this, the correlation between FCR scores and the study variables was evaluated. RESULTS A total of 123 patients were included in the study. The translated and adapted questionnaire showed high reliability (overall Cronbach's alpha 0.834), temporal stability (intraclass correlation coefficient 0.8), and unidimensionality. The mean FCR score was 16.1 ± 6.7. The highest FCR scores were observed in women and young patients (p < 0.01). Patients with a personal history of cancer, facial melanoma, or skin graft reconstruction also obtained a high FCR score (p < 0.05). No differences were found between FCR and other tumour characteristics, such as the Breslow index or the time since diagnosis. CONCLUSIONS This validated questionnaire is suitable for evaluating FCR. We also identified factors that tend to increase FCR scores, thus allowing clinicians to identify patients at risk and start preventive measures.
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Affiliation(s)
- Álvaro Iglesias-Puzas
- Dermatology Department, Hospital Universitario Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | - Víctor García-González
- Dermatology Department, Hospital Universitario Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | - Alberto Conde-Taboada
- Dermatology Department, Hospital Universitario Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
| | - Eduardo López-Bran
- Dermatology Department, Hospital Universitario Clínico San Carlos, Complutense University of Madrid, Madrid, Spain
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17
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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: 33] [Impact Index Per Article: 16.5] [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.
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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.
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Dehghan M, Namjoo Z, Mollahoseiny Shekarabadi F, Ziaadini Dashtkhaki M, Karbakhsh Ravari Z, Kamsari Banani F, Kazemi Sarbanani F, Kalantari Khandan B, Zakeri MA. Fear of Cancer Recurrence and COVID-19 Anxiety among cancer survivors: a cross-sectional study in southeast Iran. Cancer Invest 2022; 40:629-641. [PMID: 35611836 DOI: 10.1080/07357907.2022.2082463] [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: 11/17/2022]
Abstract
Cancer survivors face numerous therapeutic and health challenges during the COVID-19 epidemic. These patients experience high levels of anxiety and stress due to illness, external stresses, and crises, such as the COVID-19 epidemic. The present study showed a positive relationship between FCR and COVID-19 anxiety as well as moderate levels of FCR (according to the midpoint score of the questionnaire) and COVID-19 anxiety among cancer survivors. Factors affecting the mental condition of cancer survivors can play an important role in completing treatment and preventing disease exacerbation.
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Affiliation(s)
- Mahlagha Dehghan
- Assistant Professor, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Postal Address: Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran
| | - Zakieh Namjoo
- B.Sc. in Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Mollahoseiny Shekarabadi
- B.Sc. student of Nursing, Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Ziaadini Dashtkhaki
- B.Sc. student of Nursing, Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Karbakhsh Ravari
- B.Sc. student of Nursing, Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Kamsari Banani
- B.Sc. student of Nursing, Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Kazemi Sarbanani
- B.Sc. student of Nursing, Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Behjat Kalantari Khandan
- Associate Professor of Hematology & Oncology, Department of Internal Medicine, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- MSc in nursing, Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,MSc in nursing, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Luo X, Li W, Chen Y, Sun H, Humphris G, Liu T, Zhang J, Yang Y, Zhang B. Fear of Recurrence in Chinese Cancer Patients: Prevalence, Correlates, and Network Analysis. Front Psychiatry 2022; 13:803543. [PMID: 35197876 PMCID: PMC8859333 DOI: 10.3389/fpsyt.2022.803543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a significant issue for most cancer patients. Until now, a detailed investigation of the structure of FCR and the interaction among its constituent elements is lacking. This study aims to investigate the phenomenon of FCR by means of network analysis in Chinese cancer patients. METHODS This is a multi-center, cross-sectional study that included 996 cancer patients from southern China. All participants were assessed by the 7-item Chinese version Fear of Cancer Recurrence Scale (FCR-7). Multivariate logistic regression, and network analyses were conducted. Central symptoms (nodes) in the FCR network were identified. RESULTS Among the 996 patients, 543 (54.52%) reported moderate FCR, and 137 (13.76%) reported high FCR. Chemotherapy (OR = 2.954, P = 0.016), and childhood severe illness experience (OR = 2.331, P = 0.016) were positively associated with high FCR, while higher monthly income (OR = 0.403, P = 0.046) was negative associated with high FCR. The node #FCR2 (Worried/anxious about recurrence) was the most central node within the FCR network (Strength = 1.190), while node #FCR6 (Examining for physical signs) was the least central node (Strength = 0.373). The edge FCR1-FCR2 ("Afraid"-"Worried/anxious") was the thickest and most saturated edge in the network. After controlling for age and gender, an almost identical network was obtained with respect to edges magnitude and strength. CONCLUSION Fear of recurrence is a frequently reported issue among Chinese cancer patients. Patients with chemotherapy and childhood severe illness experience were more vulnerable and should be particularly monitored. Compared to behavioral component (i.e., body checking, overscreening and overtreatment) and cognitive component (i.e., intrusions), emotional component (i.e., worry/anxious) is more central to identify FCR and might be potential targets for further interventions.
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Affiliation(s)
- Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, 999 Brain Hospital, Guangzhou, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Gerry Humphris
- Department of Health Psychology, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
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20
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Li W, Xu Y, Luo X, Wen Y, Ding K, Xu W, Garg S, Yang Y, Sun H. Alleviating Excessive Worries Improves Co-Occurring Depression and Pain in Adolescent and Young Adult Cancer Patients: A Network Approach. Neuropsychiatr Dis Treat 2022; 18:1843-1854. [PMID: 36045943 PMCID: PMC9423732 DOI: 10.2147/ndt.s376408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Anxiety, depression, and pain are highly interactive with each other in adolescent and young adult (AYA) cancer patients. This study aims to map out the connectivity between anxiety, depression and pain symptoms amongst Chinese AYA cancer patients from the perspective of a network model. METHODS Two hundred and eighteen AYA patients, aged between 15 and 39 years at diagnosis; completed the Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder (GAD), and McGill Pain Questionnaire-Visual Analogue Scale (MPQ-VAS). Network analyses were performed. RESULTS In all, 38.07% (95% CI = 31.58-44.57%) of the participants reported depression, 30.73% (95% CI = 24.56-36.91%) reported anxiety, and 14.22% (95% CI = 9.55-18.89%) reported current pain. The generated network illustrated that anxiety, depression and pain community were well connected. In the network, "having trouble relaxing" (GAD4, node strength = 1.182), "uncontrollable worry" (GAD2, node strength = 1.165), and "sad mood" (PHQ2, node strength = 1.144) were identified as the most central symptoms, while "uncontrollable worry" (GAD2, bridge strength = 0.645), "guilty" (PHQ6, bridge strength = 0.545), and "restlessness" (GAD5, bridge strength = 0.414) were the key bridging symptoms that connected different communities. CONCLUSION Anxiety, depression and pain symptoms are highly interactive with each other. Alleviating AYA cancer patient's excessive worries might be helpful in improving the patient's co-occurring anxiety, depression and pain symptoms.
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Affiliation(s)
- Wengao Li
- Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Yining Xu
- Department of Nursing, Guangzhou First People's Hospital, the Second Affiliated Hospital, South China University of Technology, Guangzhou, Guangdong, 510000, People's Republic of China
| | - Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Youlu Wen
- Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Kairong Ding
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.,Guangdong Mental Health Center,Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, 510080, People's Republic of China
| | - Wenjing Xu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.,Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong, 510080, People's Republic of China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, EH8 9BL, UK
| | - Yuan Yang
- Guangdong Mental Health Center,Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, 510080, People's Republic of China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong, 510080, People's Republic of China
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21
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Peikert ML, Inhestern L, Krauth KA, Escherich G, Rutkowski S, Kandels D, Schiekiera LJ, Bergelt C. Fear of progression in parents of childhood cancer survivors: prevalence and associated factors. J Cancer Surviv 2021; 16:823-833. [PMID: 34302272 PMCID: PMC9300493 DOI: 10.1007/s11764-021-01076-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/14/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Recent research demonstrated that fear of progression (FoP) is a major burden for adult cancer survivors. However, knowledge on FoP in parents of childhood cancer survivors is scarce. This study aimed to determine the proportion of parents who show dysfunctional levels of FoP, to investigate gender differences, and to examine factors associated with FoP in mothers and fathers. METHODS Five hundred sixteen parents of pediatric cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system (CNS) tumor) were consecutively recruited after the end of intensive cancer treatment. We conducted hierarchical multiple regression analyses for mothers and fathers and integrated parent-, patient-, and family-related factors in the models. RESULTS Significantly more mothers (54%) than fathers (41%) suffered from dysfunctional levels of FoP. Maternal FoP was significantly associated with depression, a medical coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and lower family functioning (adjusted R2 = .30, p < .001). Paternal FoP was significantly associated with a lower level of education, depression, a family coping style, a child diagnosed with a CNS tumor in comparison to leukemia, and fewer siblings (adjusted R2 = .48, p < .001). CONCLUSIONS FoP represents a great burden for parents of pediatric cancer survivors. We identified associated factors of parental FoP. Some of these factors can be targeted by health care professionals within psychosocial interventions and others can provide an indication for an increased risk for higher levels of FoP. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial support targeting FoP in parents of childhood cancer survivors is highly indicated.
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Affiliation(s)
- Mona L Peikert
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Konstantin A Krauth
- Department of Pediatrics, Pediatric Hematology and Oncology, Klinik Bad Oexen, Oexen 27, 32549, Bad Oeynhausen, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Daniela Kandels
- Swabian Children's Cancer Center, Medical Faculty, University of Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - Louis J Schiekiera
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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22
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Butow P, Müller F, Napier CE, Bartley N, Ballinger ML, Biesecker B, Juraskova I, Meiser B, Schlub TE, Thomas DM, Goldstein D, Best MC. Longitudinal patterns in fear of cancer progression in patients with rare, advanced cancers undergoing comprehensive tumour genomic profiling. Psychooncology 2021; 30:1920-1929. [PMID: 34240516 DOI: 10.1002/pon.5764] [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: 12/08/2020] [Revised: 06/13/2021] [Accepted: 07/05/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Fear of cancer progression (FCP) impacts quality of life and is a prevalent unmet need in patients diagnosed with advanced cancer, particularly as treatment options are reduced. We aimed to identify longitudinal patterns in FCP over 6 months in patients with advanced cancer receiving comprehensive tumour genomic profiling (CTGP) results, and their correlates. METHODS Patients with pathologically confirmed metastatic disease (∼70% rare cancers) receiving or post their last line of standard therapy completed questionnaires at T0 (prior to CTGP), T1 (immediately post CTGP results) and T2 (2 months later). RESULTS High stable (N = 52; 7.3%) and low/moderate stable (N = 56; 7.8%) FCP patterns over time typified the largest participant groups (N = 721). Those with an immediately actionable variant versus a non-actionable variant (p = 0.045), with higher FCP (p < 0.001), and lower Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) scores (p = 0.006) at T0, had higher FCP at T1. Those with higher FCP at T0 (p < 0.001) and at T1 (p < 0.001), lower FACIT-Sp scores at T1 (p = 0.001), lower education (p = 0.031) and female gender (p = 0.027) had higher FCP at T2. DISCUSSION Routine screening for psychological/spiritual characteristics in those about to undergo CTGP may help to identify patients who may benefit from closer monitoring and provision of psychosocial support. Future studies should explore interventions to best address FCP in this vulnerable group, as interventions assessed to date have almost all addressed patients with curative cancers or newly diagnosed advanced disease.
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Affiliation(s)
- Phyllis Butow
- School of Psychology, Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabiola Müller
- Faculty of Science, School of Psychology, Quality of Life Office, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Christine E Napier
- Cancer Theme, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Nicci Bartley
- School of Psychology, Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia
| | - Mandy L Ballinger
- Cancer Theme, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | | | - Ilona Juraskova
- School of Psychology, Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia
| | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, University of New South Wales, Kensington, New South Wales, Australia
| | - Timothy E Schlub
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David M Thomas
- Cancer Theme, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - David Goldstein
- Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Megan C Best
- School of Psychology, Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Ethics and Society, University of Notre Dame, Broadway, New South Wales, Australia
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23
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Sense of coherence as a mediator between perceived stress and depression in newly diagnosed breast cancer patients: a cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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24
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Ahmad MH, Rizvi MA, Fatima M, Mondal AC. Pathophysiological implications of neuroinflammation mediated HPA axis dysregulation in the prognosis of cancer and depression. Mol Cell Endocrinol 2021; 520:111093. [PMID: 33253761 DOI: 10.1016/j.mce.2020.111093] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/02/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023]
Abstract
Cancer patients are more likely to develop depressive symptoms and show a poor prognosis compared to the normal healthy individuals. Cancer occurrence and the anticancer treatments result in the pro-inflammatory cytokines-mediated inflammation, which dysregulates the HPA-axis activity that may result in depression-like behaviour. Conversely, depression causes the activation of the HPA-axis that results in the downstream release of endogenous glucocorticoids which may result in depressive signs and symptoms in some cancer patients. Depression may also result in non-adherence to treatment and increased mortality in cancer patients. In this review, we have focused on the role of neuroimmune axis and hyperactive HPA-axis in case of both cancer and depression. Therefore, therapeutics targeting the HPA-axis dysregulation could be effective in ameliorating symptoms of depression in cancer patients.
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Affiliation(s)
- Mir Hilal Ahmad
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India; Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India
| | | | - Mahino Fatima
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Amal Chandra Mondal
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.
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25
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Li MC, Cheng HL. Fear of cancer recurrence, supportive care needs, and the utilization of psychosocial services in cancer survivors: A cross-sectional survey in Hong Kong. Psychooncology 2020; 30:602-613. [PMID: 33247969 DOI: 10.1002/pon.5609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is the top-ranked psychological concern in cancer survivors. We examined the prevalence of FCR and the relationships among FCR, supportive care needs, and the utilization of psychosocial services among Chinese cancer survivors. METHODS This cross-sectional, correlational study included 311 cancer survivors within 5 years of survivorship in Hong Kong. The participants were invited to complete an online survey: the Fear of Progression Questionnaire-Short Form to assess FCR; the 34-item Supportive Care Needs-Short Form to assess supportive care needs, and a self-constructed questionnaire to assess psychosocial services utilization. A score of ≥34 indicated FCR. Descriptive statistics and hierarchical regression analyses were performed. RESULTS Of the participants surveyed, 38.3% were classified as having FCR. The most frequently reported supportive care needs in five domains were in the psychological domain (M = 39.5; SD = 27.6), followed by the health system and information domain (M = 38.6, SD = 26.9). Of the three categories of psychosocial services, informational/educational healthcare services were the most frequently utilized (81%), while the least utilized services were mental health/psychological well-being support (46.9%). FCR was a consistent factor that was associated with needs in five domains (b = 8.73-39.58, all p < 0.001). However, FCR was not associated with any of the three categories of psychosocial services utilization. CONCLUSION FCR is frequent in cancer survivors. FCR may play an important role in supportive care needs, but not in psychosocial services utilization. There is an increasing demand to bridge the service gap between the need for and the use of mental health and psychological well-being services.
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Affiliation(s)
- Man Chung Li
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Hui Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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26
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Luo X, Li W, Yang Y, Humphris G, Zeng L, Zhang Z, Garg S, Zhang B, Sun H. High Fear of Cancer Recurrence in Chinese Newly Diagnosed Cancer Patients. Front Psychol 2020; 11:1287. [PMID: 32581984 PMCID: PMC7296085 DOI: 10.3389/fpsyg.2020.01287] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/15/2020] [Indexed: 01/07/2023] Open
Abstract
Background Fear of cancer recurrence (FCR) is common among cancer patients and of high clinical relevance. This study explores the prevalence and correlates of FCR in Chinese newly diagnosed cancer population. Methods This is a multicentre, cross-sectional study that includes 996 patients with mixed cancer diagnosis. All recently diagnosed patients completed a questionnaire consisting of the following: Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire (PHQ-9). Univariate analyses, multivariate logistic regression analyses, and structural equation modeling (SEM) was performed to examine the association between tested variables and FCR. Results Of the 996 patients, 643 (64.6%) reported high FCR (scored ≥ 34 in the FoP-Q-SF). Chemotherapy (OR = 1.941), Childhood severe illness experience (OR = 2.802), depressive (OR = 1.153), and anxiety (OR = 1.249) symptoms were positively associated with high FCR, while higher monthly income (OR = 0.592) was negatively associated with high FCR. SEM indicated that emotional disturbances (anxiety and depression) directly influenced FCR, while emotional disturbances partly mediated the association between personal monthly income and FCR. Conclusion High FCR is a frequently reported problem among newly diagnosed cancer patients. Various factors increased the likelihood of the development of FCR. Flexible psychological interventions are needed for patients with high FCR.
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Affiliation(s)
- Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Gerald Humphris
- School of Medicine, University of St Andrews, St Andrews, United Kingdom.,Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Lijuan Zeng
- Department of Organ Transplantation, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zijun Zhang
- CNSST Foundation New Zealand, Panmure, Auckland, New Zealand
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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27
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Lim E, Humphris G. The relationship between fears of cancer recurrence and patient age: A systematic review and meta-analysis. Cancer Rep (Hoboken) 2020; 3:e1235. [PMID: 32671982 DOI: 10.1002/cnr2.1235] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Fears of cancer recurrence (FCR) is one of the most prevalent concerns and a common unmet need reported by cancer patients. Patient age is a demographic variable that has been linked to FCR, among others. Although it is recognised by researchers that age and FCR may be negatively correlated, the strength of this correlation has yet to be established. AIM The aims of this study were to (a) conduct a meta-analysis to investigate the overall association of patient age in years with FCR across studies from 2009 to February 2019 and (b) scrutinise for patterns of these effect sizes across studies. METHODS AND RESULTS Peer-reviewed papers were gathered from the literature via online databases (PubMed, EMBASE, MEDLINE, and PsycINFO). Systematic review guidelines including a quality assessment were applied to the 31 selected studies (pooled participant N size = 19 777). The meta-analysis demonstrated a significant negative association between age and FCR (ES = -0.12; 95% CI, -0.17, -0.07). Meta-regression revealed the association of patient age and FCR significantly reduced over the last decade. A significant effect (β = -0.17, P = 0.005) of breast cancer versus other cancers on this age by FCR association was also identified. CONCLUSION The reliable and readily accessible personal information of age of patient can be utilised as a weak indicator of FCR level especially in the breast cancer field, where the majority of studies were drawn. The suggestion that age and FCR association may be attenuated in recent years requires confirmation.
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Affiliation(s)
- Edward Lim
- Medical School, University of St Andrews, St Andrews, UK
| | - Gerald Humphris
- Medical School, University of St Andrews, St Andrews, UK.,Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
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28
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Zhang Y, Li W, Zhang Z, Sun H, Garg S, Yang Y, Wang H. Suicidal Ideation in Newly-Diagnosed Chinese Cancer Patients. Front Psychiatry 2020; 11:708. [PMID: 32793000 PMCID: PMC7390886 DOI: 10.3389/fpsyt.2020.00708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/06/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Suicide is one of the main reasons cited behind the death rate of cancer, and suicidal ideation (SI) is the first step toward it. This study aimed to investigate the prevalence and associates of suicidal ideation in newly-diagnosed Chinese cancer patients. METHODS This multicenter study was conducted from January 2018 to September 2019. Eligible participants were asked to complete a Case Record Form (CRF), the Patient Health Questionnaire (PHQ-9), General Anxiety Disorder Questionnaire (GAD-7), Fear of Cancer Recurrence Questionnaire (FCRQ-7), and McGill Pain Questionnaire-Visual Analogue Scale (MPQ-VAS). Univariate analyses and multivariate logistic regression analyses were conducted for assessment. RESULTS Out of 603 patients, 91 (15.1%, 95%CI: 12.23%-17.96%) reported suicidal ideation in the last 2 weeks. Physical comorbidities (OR=1.808, P=0.039), childhood adversity experience (OR=5.999, P=0.001), cancer pain (OR=1.828, P=0.047), depression (OR=2.811, P=0.013), and anxiety (OR=6.532, P<0.001) were significantly associated with suicidal ideation. It was also found that patients who regularly exercised were less likely to report suicidal thoughts (OR=0.172, P=0.007). CONCLUSION Physical comorbidities, body ache, and mood disturbances are possible risk factors for suicidal ideation that warrant further attention in clinical practice. Preventive measures, such as systematic screening and arrangement for regular check-ups, could be beneficial to lower the risk of suicide.
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Affiliation(s)
- Yongfu Zhang
- Department of Anesthesiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Zijun Zhang
- Social Work and Counselling Team, CNSST Foundation, Auckland, New Zealand
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Hongmei Wang
- Department of Radiation Oncology, Southern Medical University Nanfang Hospital, Guangzhou, China
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29
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Affiliation(s)
- Jess G Fiedorowicz
- Departments of Psychiatry, Epidemiology and Internal Medicine, Abboud Cardiovascular Research Center, Obesity Research and Education Initiative, Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, United States.
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30
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Yang Y, Li W, Wen Y, Wang H, Sun H, Liang W, Zhang B, Humphris G. Fear of cancer recurrence in adolescent and young adult cancer survivors: A systematic review of the literature. Psychooncology 2019; 28:675-686. [PMID: 30703261 DOI: 10.1002/pon.5013] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/16/2019] [Accepted: 01/25/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The current systematic review aims to provide an overview of fear of cancer recurrence (FCR) in adolescent and young adult cancer survivors (15-39 years at cancer diagnosis, AYAs). METHODS MEDLINE, PubMed, PsycINFO, and Embase databases were independently searched to identify relevant quantitative articles. PRISMA systematic review procedures were followed with quality assessment. RESULTS Seventeen studies were included in the current review. All were quantitative studies that utilized a cross-sectional study design. Seven articles reported results of FCR prevalence, six studied determinants related to FCR, and 11 articles provided information about consequences of FCR. Prevalence of FCR ranged from 31% to 85.2% among AYA survivors. Associations between sociodemographic/clinical variables and FCR were inconsistent. Psychological distress and higher treatment intensity were positively associated with higher FCR levels. Lower scores on levels of physical, psychological functioning, and overall health-related quality of life (QoL) were identified as consequences of increased FCR. CONCLUSION FCR appears to be a prevalent concern among adolescent and young adult cancer populations. Adequate assessment to determine need for support and intervention is still required. Longitudinal studies in AYAs are warranted to understand the development and potential influence of FCR. Age-appropriate and flexible psychological care would be more successful potentially with this crucial background information.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Wen Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Yunhong Wen
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Centre, Guangdong General Hospital, Guangzhou, Guangdong, China
| | - Weijiang Liang
- Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Gerry Humphris
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, UK
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31
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Sun H, Yang Y, Zhang J, Liu T, Wang H, Garg S, Zhang B. Fear of cancer recurrence, anxiety and depressive symptoms in adolescent and young adult cancer patients. Neuropsychiatr Dis Treat 2019; 15:857-865. [PMID: 31118635 PMCID: PMC6498985 DOI: 10.2147/ndt.s202432] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/01/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Previous studies have indicated that younger age is consistently associated with high levels of fear of cancer recurrence (FCR), anxiety and depression. However, the associations among these variables in adolescent and young adult (AYA) cancer patients are not clear. This study explores the prevalence and correlates of FCR, anxiety and depressive symptoms in Chinese AYA cancer population. Methods: This is a cross-sectional study that includes 249 patients aged between 15 and 39 yrs at the time of cancer diagnosis. Patient's sociodemographic, clinical as well as psychological characteristics were collected by an information sheet, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). Descriptive statistics and multivariate analyses were conducted. Results: Eighty-nine (35.74%) patients experienced dysfunctional level of FCR, eighty-two (32.93%) patients experienced anxiety symptoms and ninety-six (38.55%) reported depressive symptoms. In multivariate analyses, being single, pessimistic, having more concurrent stressful life events and physical comorbidity were independently associated with higher FCR, anxiety and depressive symptoms. Patients who were not engaging in radiotherapy were more likely to report higher anxiety level. Conclusion: FCR, anxiety and depressive symptoms are frequently reported problems among AYA cancer patients. Age-appropriate and flexible psychological interventions are needed for this high-risk population.
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Affiliation(s)
- Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, People's Republic of China
| | - Yuan Yang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, Macau.,Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence, Guangzhou, 510515, People's Republic of China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence, Guangzhou, 510515, People's Republic of China
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence, Guangzhou, 510515, People's Republic of China
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou 510515, People's Republic of China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9BL, UK
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence, Guangzhou, 510515, People's Republic of China
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