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Yang L, Li Y, Wang X, Xia C, Yang L, Li X, Zou Y, Wang Q, Hou Q, Duan P, Zhang Z. Examining the role of resilience in the relationship between social support and fear of recurrence among patients with gastric cancer on chemotherapy: a cross-sectional study in Jiangsu, China. BMJ Open 2024; 14:e078679. [PMID: 38885993 PMCID: PMC11184204 DOI: 10.1136/bmjopen-2023-078679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/04/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES The objective of this study is to investigate the relationships between fear of cancer recurrence (FCR), social support and resilience, and further determine whether resilience mediates social support and FCR among Chinese patients with gastric cancer undergoing chemotherapy. DESIGN Multicentre cross-sectional survey. SETTING Four hospitals in Jiangsu Province, China, with grade-A tertiary hospital settings. PARTICIPANTS 755 patients with gastric cancer on chemotherapy across four hospitals in China were included from March 2021 to September 2022. OUTCOME MEASURES The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Connor-Davidson Resilience Scale (CD-RISC) and Social Support Rating Scale (SSRS) were used to test the model's constructs. Statistical analyses were conducted by using IBM SPSS V.26.0 software. PROCESS V.3.4 macro was used to analyse the mediating role of resilience in the relationship between social support and FCR. RESULTS The mean scores for SSRS, CD-RISC and FoP-Q-SF in patients with gastric cancer receiving chemotherapy were 41.55±7.79, 54.83±18.46 and 30.91±10.11, respectively. 43.3% (n=327) had psychological dysfunction, 56.8% (n=429) had low to medium resilience and 99.1% (n=748) had medium to robust social support. Significant differences exist among three variables, resilience positively correlated with social support, while FCR negatively correlated with resilience and social support (p<0.001). Resilience fully mediated the relationship between social support and FCR (a*b-path=-0.126, 95% CI -0.169 to -0.086). CONCLUSIONS Mediation analysis shows resilience mediates social support and FCR in patients with gastric cancer as the negative effect of social support on FCR was fully mediated by resilience. Interventions targeting these variables may reduce FCR in patients with gastric cancer undergoing chemotherapy.
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Affiliation(s)
- Lihua Yang
- School of Nursing, Jiangsu Health Vocational College, Nanjing, Jiangsu Province, China
| | - Yi Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xiaoqing Wang
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Chao Xia
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Liping Yang
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Xun Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Yanling Zou
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Qiong Wang
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Qingmei Hou
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Peibei Duan
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Ziyan Zhang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
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Wu S, Guo X, Tang H, Li Y, Dong W, Lu G, Hou C, Chen C. The Relationship Between Illness Uncertainty and Social Support Among Cancer Patients: A Meta-analysis. Cancer Nurs 2024:00002820-990000000-00223. [PMID: 38447045 DOI: 10.1097/ncc.0000000000001328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND As a common psychological problem in cancer patients, illness uncertainty has attracted wide attention from scholars. Some studies have pointed out that the level of social support may affect illness uncertainty in patients with cancer, but the results of these studies remain controversial. OBJECTIVE The aim of this study was to evaluate the correlation between illness uncertainty and social support in patients with cancer using meta-analysis. METHODS PubMed, Web of Science, EMBASE, EBSCO, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Citation Database were searched for articles published up to 2022. The screening of the literature, data extraction, and quality assessment of the included studies were performed independently by 2 researchers. Stata 17.0 software was used to analyze the overall and moderation effects. RESULTS Notably, 41 studies involving 5403 patients were included. The results showed that the illness uncertainty of adults with cancer was moderately negatively correlated with social support (r = -0.33). Country, publication year, cancer type, and instrument used to measure social support moderated the association between illness uncertainty and social support. CONCLUSION Improving the level of social support can reduce illness uncertainty experienced by adults with cancer to a certain extent. IMPLICATIONS FOR PRACTICE This review provides a clear direction for implementing precise interventions to reduce illness uncertainty among adults with cancer. Furthermore, patients with cancer with high morbidity and mortality rates deserve greater attention from healthcare personnel and family caregivers.
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Affiliation(s)
- Sijia Wu
- Author Affiliations: Institute of Nursing and Health, School of Nursing and Health (Mss Wu, Guo, Tang, Li, Dong, and Hou, and Dr Chen); and Institute of Business Administration, School of Business (Dr Lu), Henan University, Kaifeng, China
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Calderon C, Gustems M, Galán-Moral R, Muñoz-Sánchez MM, Ostios-García L, Jiménez-Fonseca P. Fear of Recurrence in Advanced Cancer Patients: Sociodemographic, Clinical, and Psychological Correlates. Cancers (Basel) 2024; 16:909. [PMID: 38473270 DOI: 10.3390/cancers16050909] [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: 02/02/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Fear of cancer recurrence significantly impacts advanced cancer patients, prompting emotional distress and increased healthcare utilization. This present study aims to analyze the fear of recurrence among patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A multicenter cross-sectional study was conducted in 15 oncology departments across Spain, involving patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants provided demographic information and completed instruments such as the Cancer Worry Scale, Brief Symptom Inventory, Mishel Uncertainty in Illness Scale, and the Duke-UNC-11 Functional Social Support Questionnaire (DUFSSQ). A total of 1195 participants participated: median age 66, 56% male, mostly metastatic cancers (80%), and common tumor sites. Two fear groups emerged: 28% low and 72% high levels of fear. High fear was associated with being female, being younger, lower levels of education, and worse survival estimates. High fear correlated with more depression, anxiety, somatic symptoms, uncertainty, and stronger social support. Multivariate analyses indicated that younger patients, those with shorter survival estimates, higher depression and anxiety scores, more uncertainty, and stronger social support had a greater likelihood of experiencing fear of recurrence, while the opposite was true for older patients. This study underscores distinct fear of recurrence profiles in advanced cancer patients, emphasizing the need for targeted interventions and support. Future research should delve deeper into understanding their repercussions for improving patient care and well-being.
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Affiliation(s)
- Caterina Calderon
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Marina Gustems
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Rocio Galán-Moral
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, 13005 Madrid, Spain
| | - Maria M Muñoz-Sánchez
- Department of Medical Oncology, Hospital General Virgen de la Luz, 16002 Cuenca, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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Li B, Lin X, Chen S, Qian Z, Wu H, Liao G, Chen H, Kang Z, Peng J, Liang G. The association between fear of progression and medical coping strategies among people living with HIV: a cross-sectional study. BMC Public Health 2024; 24:440. [PMID: 38347483 PMCID: PMC10860317 DOI: 10.1186/s12889-024-17969-1] [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: 06/07/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Due to the chronic nature of HIV, mental health has become a critical concern in people living with HIV (PLWHIV). However, little knowledge exists about the association between fear of progression (FoP) and medical coping modes (MCMs) in PLWHIV in China. METHODS A cohort of 303 PLWHIV were consecutively enrolled and their demographic, clinical and psychological information was collected. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS), Internalized HIV Stigma Scale (IHSS) and MCMs Questionnaire were utilized. RESULTS Of the participants, 215 PLWHIV were classified into the low-level FoP group, and 88 were grouped into the high-level FoP group based on their FoP-Q-SF scores, according to the criteria for the classification of dysfunctional FoP in cancer patients. The high-level group had a higher proportion of acquired immunodeficiency syndrome (AIDS) stage (P = 0.005), lower education levels (P = 0.027) and lower income levels (P = 0.031). Additionally, the high-level group had lower scores in social support (P < 0.001) and its three dimensions, with total SSRS scores showing a negative correlation with two dimensions of FoP-Q-SF, namely physical health (r2 = 0.0409, P < 0.001) and social family (r2 = 0.0422, P < 0.001). Further, the high-level group had higher scores in four dimensions of internalized HIV stigma, and a positive relationship was found to exist between IHSS scores and FoP-Q-SF scores for physical health (r2 = 0.0960, P < 0.001) and social family (r2 = 0.0719, P < 0.001). Social support (OR = 0.929, P = 0.001), being at the AIDS stage (OR = 3.795, P = 0.001), and internalized HIV stigma (OR = 1.028, P < 0.001) were independent factors for FoP. Furthermore, intended MCMs were evaluated. FoP were positively correlated with avoidance scores (r2 = 0.0886, P < 0.001) and was validated as the only factor for the mode of confrontation (OR = 0.944, P = 0.001) and avoidance (OR = 1.059, P = 0.001) in multivariate analysis. CONCLUSION The incidence of dysfunctional FoP in our study population was relatively high. High-level FoP was associated with poor social support, high-level internalized HIV stigma and a negative MCM among PLWHIV.
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Affiliation(s)
- Bing Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xiaoli Lin
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Suling Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zhe Qian
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Houji Wu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Guichan Liao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Hongjie Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Zixin Kang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Guangyu Liang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Nic Giolla Chomhaill C, Ward J, Dowling M. Fear of recurrence in women with ovarian cancer: A qualitative evidence synthesis. Eur J Oncol Nurs 2024; 68:102487. [PMID: 38113769 DOI: 10.1016/j.ejon.2023.102487] [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: 09/08/2023] [Revised: 11/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Approximately 80% of ovarian cancers recur after first-line treatments. Women with ovarian cancer (OC) are therefore particularly vulnerable to experiencing fear of cancer recurrence (FCR). This study aimed to synthesise experiences of fear of cancer recurrence among women living with ovarian cancer. METHOD A qualitative evidence synthesis (QES) was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A systematic search of seven databases was undertaken to identify all available qualitative research exploring fear of cancer recurrence in women with OC. Thematic synthesis of extracted data from included studies was undertaken and managed in NVivo. RESULTS Twenty-two papers reporting on eighteen studies were included in the synthesis. Three main themes were developed (triggers, responses, and coping) and included ten subthemes. FCR was triggered by factors relating to awareness of prognosis, treatment, and negative communication. Women responded to FCR by performing body checking and protecting their families. FCR led to adverse effects on women's wellbeing as it exacerbated uncertainty about their future. Women attempted to cope with FCR through seeking support, regaining control, and redirecting negative thoughts and actions. CONCLUSIONS Women use a variety of approaches to manage their fear of recurrence. Further research on the most appropriate interventions for FCR tailored specifically to the needs of women with OC is needed.
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Affiliation(s)
| | - Jana Ward
- Occupational Therapy Department, Galway University Hospital, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
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Li Y, Li N, Wang J, Shang Q, Zhang B, Cao M. Effects of Social Support, Family Resilience, and Individual Resilience on Fear of Cancer Recurrence Among Persons With Breast Cancer: A Cross-Sectional Study. West J Nurs Res 2023; 45:993-1000. [PMID: 37732426 DOI: 10.1177/01939459231200772] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND There is limited research exploring the psychological and social predictors of fear of cancer recurrence (FCR). OBJECTIVE This study tested the effects of social support, family resilience, and individual resilience on FCR among persons with breast cancer. METHODS A convenience sampling method was used to select 214 participants from March to August 2021 in 1 tertiary hospital in Jinan, China. Data were collected using self-administered questionnaires. Path analysis was adopted to explore the effects of social support, family resilience, and individual resilience on FCR. RESULTS Findings showed that 94.6% of the participants reached a clinical level of FCR. Social support (β = -.75, p < .01) and individual resilience (β = -.32, p < .01) negatively and directly impacted FCR. Family resilience indirectly impacted FCR through individual resilience (β = -.22, 95% confidence interval (CI): -.34 to -.08). Social support indirectly impacted FCR through family resilience and individual resilience (β = -.15, 95% CI: -.23 to -.06). CONCLUSIONS Persons with breast cancer experienced a high level of FCR. Individual resilience was a mediator between family resilience and FCR. Resilience (individual resilience and family resilience) partially mediated the effects of social support on FCR. The findings indicate that measures focused on improving individual resilience, family resilience, and social support should be considered by nurses, which are helpful for easing FCR.
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Affiliation(s)
- Yan Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Na Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jinfang Wang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qiongqiong Shang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Benyan Zhang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mengke Cao
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
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Hong S, Lee J, Lee J, Chang JH, Park CG, Kim TH. The Mediating Effect of Uncertainty in Illness on Cancer Coping in Patients With Primary Malignant Brain Tumors. Cancer Nurs 2023; 46:467-476. [PMID: 36480344 DOI: 10.1097/ncc.0000000000001177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with primary malignant brain tumors (PMBTs) experience uncertainty in illness (UI) because of the high recurrence rate and symptoms that occur during treatment. OBJECTIVE To develop and test a model based on the Uncertainty in Illness Theory to predict the UI and cancer coping experienced by PMBT patients. METHODS This was a cross-sectional study using path analysis. The participants were adults diagnosed with PMBT who completed a questionnaire about demographic and disease-related characteristics, UI, cancer coping, brain tumor symptoms, and social support. Clinical data (eg, the diagnosis, tumor location, and grade) were obtained from electronic health records. Data were analyzed using SPSS 26.0 and the MVN , psych , and lavaan packages in R 4.1.0. RESULTS This study included 203 PMBT patients. The hypothesized model satisfied all statistical criteria (comparative fit index = 0.998, root mean square error of approximation = 0.044, standardized root mean square residual = 0.016). The indirect and direct associations of UI in the path from social support to cancer coping were all significant with a 95% bootstrapping confidence interval. Although the indirect and direct associations of UI in the path of brain tumor symptoms and cancer coping did not have direct or total effects, the indirect effect was statistically significant. CONCLUSIONS Uncertainty in illness mediated brain tumor symptoms and social support to predict cancer coping. IMPLICATIONS FOR PRACTICE A nurse-led intervention for cancer coping among PMBT patients can be developed by considering symptoms and social support and UI as a mediator.
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Affiliation(s)
- Soomin Hong
- Author Affiliations: College of Nursing and Brain Korea 21 FOUR Project (Dr Hong), Mo-Im Kim Nursing Research Institute, College of Nursing (Drs J. H. Lee and J. Lee), and Department of Neurosurgery, College of Medicine (Dr Chang), Yonsei University, Seoul, South Korea; College of Nursing, University of Illinois, Chicago (Dr Park); and Division of Nursing, Yongin Severance Hospital, Yonsei University Health System, Gyeonggi, South Korea (Dr Kim)
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Zheng M, Wang S, Zhu Y, Wan H. Trajectories of fear of progression in nasopharyngeal carcinoma patients receiving proton and heavy ion therapy. Support Care Cancer 2023; 31:630. [PMID: 37843679 DOI: 10.1007/s00520-023-08085-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The study examined the growth trajectory of fear of progression(FOP) in nasopharyngeal carcinoma (NPC) patients. In addition, sociodemographic and clinical variables of each trajectory class were analyzed. METHOD Two hundred sixteen NPC patients undergoing proton and heavy ion therapy were measured beginning (T0) and end of a 4-week proton and heavy ion therapy (T1), 3 months (T2) and 6 months (T3) after discharge. And data from the final 197 NPC patients were analyzed. NPC patients' FOP was investigated by the Fear of Progression Questionnaire-Short Form (FOP-Q-SF) form T0 to T3. SPSS and Mplus were used for statistical analysis. The LGMM was used to analyze the trajectory of FOP followed up over 6 months after proton and heavy ion therapy. The logistic regression was utilized to compare the differences in sociodemographic and clinical characteristics of patients in different trajectory groups of FOP. RESULTS One hundred ninety-seven NPC patients were analyzed. LGMM analysis showed that three-group trajectory solution was the best fitting (low-fear decline FOP (14.21%), the moderate-fear stable FOP(43.15%), and high-fear rising FOP (42.64%). Significant positive associations were found between age < 30 years (β = 3.399, p = 0.023), with or without children (β = 3.1, p = 0.002), primary/recurrence (β = -6.196, p < 0.001), diagnosis < 3 months (β = 4.435, p = 0.031), high school education (β = 2.98, p = 0.048), and high fear rising FOP. Patients who had moderate financial stress (β = 2.51, p = 0.041), with or without children (β = 1.564, p = 0.003), primary/recurrence (β = -2.578, p = 0.005), less than 30 radiotherapy times (β = 0.979, p = 0.046) tended to report significant moderate-fear stable FOP over time. CONCLUSION 42.64% of the NPC patients showed high-fear rising FOP over the 6 months after treatment. Age 18-30 years, with or without children, relapsed, diagnosis < 3 months, and high school education and reporting being a pessimist predicts higher FOP scores. Early identification of age 18-30 years, with or without children, relapsed, diagnosis < 3 months, and high school education might help to identify populations experiencing long-term FOP. Clinical teams responsible to develop the target interventions for management of FCR in clinical practice.
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Affiliation(s)
- Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
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Zheng M, Wang S, Zhu Y, Wan H. A qualitative exploration of fear of progression in patients with nasopharyngeal carcinoma treated with proton and heavy ion therapy. Support Care Cancer 2023; 31:622. [PMID: 37815579 DOI: 10.1007/s00520-023-08028-3] [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: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To investigate fear of progression (FOP) in nasopharyngeal carcinoma (NPC) patients treated with proton and heavy ion therapy. METHODS Thirty NPC patients were selected for face-to-face semistructured interviews through purposive sampling while using the phenomenological approach in qualitative research. The interviews were transcribed, organized, and analyzed by applying Colaizzi's seven-step analysis. RESULTS Seven themes were summarized, namely, illness uncertainty, trapped into insecurity (including four categories: insecurity about the possibility of discrimination, insecurity about the possibility of the inability to tolerate the pain of retreatment, insecurity about the difficulty of retreatment after recurrence, and insecurity of waiting for test results), hopelessness, loss, guilt toward children, enhancing tolerance toward family, and self-emotional comfort. CONCLUSION We found that women with children and patients who experienced their first episode underwent significant FOP. Patients at the postgraduate level and above were more inclined to feel loss. The finding that respondents expressed is intense FOP while waiting for test results, which provides a reference for the analysis of the trajectory of FOP. Health care professions should be cognitively aware the importance of eliminating patients' uncertainty and insecurity about disease to enhance their positive experience in coping with cancer.
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Affiliation(s)
- Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
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Wang T, Sun J, Gu D, Shen S, Zhou Y, Wang Z. Dyadic effects of social support, illness uncertainty on anxiety and depression among lung cancer patients and their caregivers: a cross-sectional study. Support Care Cancer 2023; 31:402. [PMID: 37338663 DOI: 10.1007/s00520-023-07876-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/10/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To explore the dyadic relationships between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and their family caregivers. To examine the potential mediating role of illness uncertainty and the moderating role of disease stage in lung cancer patient-caregiver dyads. METHODS A total of 308 pairs of lung cancer patients and their family caregivers from a tertiary hospital in Wuxi, China, from January 2022 to June 2022 were included. Participants' perceived social support, illness uncertainty, anxiety, and depression were assessed by corresponding questionnaires. To test for dyadic relationships between the variables, we employed the actor-partner interdependence mediation model. RESULTS There were actor and partner effects of both patient and caregiver perceived social support on anxiety and depression, and illness uncertainty mediated the effect of perceived social support on anxiety and depression. Lung cancer stage plays a moderating role in lung cancer patient-caregiver dyads. There is an indirect positive partner effect of perceived social support from family caregivers on anxiety and depression in patients with early lung cancer; there is a direct or indirect negative partner effect of social support from family caregivers on anxiety and depression in patients with advanced lung cancer. CONCLUSIONS This study confirmed the dyadic interdependence between perceived social support, illness uncertainty, anxiety, and depression among lung cancer patients and family caregivers. Furthermore, studies on differences between different lung cancer stages may provide a theoretical basis for different dyadic supportive interventions based on lung cancer stages.
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Affiliation(s)
- Tian Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiaojiao Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Danfeng Gu
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Siwen Shen
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yunxu Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Zhiqiang Wang
- Affiliated Hospital of Jiangnan University, Wuxi, China.
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Yang Y, Gorka SM, Pennell ML, Weinhold K, Orchard T. Intolerance of Uncertainty and Cognition in Breast Cancer Survivors: The Mediating Role of Anxiety. Cancers (Basel) 2023; 15:3105. [PMID: 37370715 DOI: 10.3390/cancers15123105] [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: 05/15/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) is one of the most prevalent symptoms that breast cancer survivors experience. While cancer treatments are established contributors to CRCI, inter-individual differences in CRCI are not well understood. Individual differences in sensitivity to uncertainty are potential contributors to CRCI; however, no prior studies have attempted to examine this link in the context of breast cancer. To address the gap, we used preliminary findings from an ongoing cross-sectional study. A total of 38 women with stage I-III breast cancer (1-4 years post-treatment) were included in this study. Intolerance of uncertainty (IU) was assessed using the Intolerance of Uncertainty Scale. Self-reported cognitive function was assessed with the Neuro-QoL questionnaire. Anxiety was assessed using the Patient-Reported Outcomes Measurement System Bank. From this study, we found that anxiety mediates the association between IU and cognitive function of survivors. In other words, among post-menopausal breast cancer survivors, those with higher IU showed higher anxiety and consequently had lower cognitive function. This finding suggests that assessing IU may help predict the risk of CRCI. This study expands the current knowledge that addresses the importance of IU as a factor associated with cognitive health.
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Affiliation(s)
- Yesol Yang
- Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, 406 W 10th Avenue, Columbus, OH 43210, USA
| | - Stephanie M Gorka
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 370 W 9th Avenue, Columbus, OH 43210, USA
- Institute for Behavioral Medicine Research, The Ohio State University, 460 Medical Center Drive, Columbus, OH 43210, USA
| | - Michael L Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA
| | - Kellie Weinhold
- Human Nutrition Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA
| | - Tonya Orchard
- Human Nutrition Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA
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Lu X, Wu C, Bai D, You Q, Cai M, Wang W, Hou C, Gao J. Relationship between social support and fear of cancer recurrence among Chinese cancer patients: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1136013. [PMID: 36970291 PMCID: PMC10031045 DOI: 10.3389/fpsyt.2023.1136013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/23/2023] [Indexed: 03/29/2023] Open
Abstract
Background To quantitatively analyze the association between social support (SS) and fear of cancer recurrence (FCR) by reviewing current evidence from observational studies. Methods A comprehensive literature search was performed in nine databases from inception to May 2022. Observational studies that used both SS and FCR as study variables were included. Regression coefficient (β') and correlation coefficient (r) were calculated with R software. Subgroup analysis was utilized to investigate the degree of the relationship between SS and FCR as well as the impact of various forms of SS on FCR in cancer patients. Results Thirty-seven studies involving 8,190 participants were identified. SS significantly reduced FCR risk [pooled β' = -0.27, 95% confidence interval (CI) = -0.364 to -0.172], with moderate negative correlations (summary r = -0.52, 95% CI = -0.592 to -0.438). Meta-regression and subgroup analysis showed that types of cancer and study type were the source of heterogeneity. However, types of SS [actual SS, perceived social support (PSS), and others], source of actual SS, and source of PSS were not significant moderators. Conclusion To the best of our knowledge, this is the first systematic review and meta-analysis to quantitatively investigate the association between SS and FCR in Chinese cancer patients using β' and r coefficients. The results re-emphasized that social workers should enhance the use of SS by cancer patients and establish a sound SS system by either implementing more relevant research or developing targeted policies. Based on meta-regression and subgroup analyses, moderators of the association between SS and FCR should also be studied closely as they may help identify patients in need. In addition, longitudinal research, as well as mixed research, should be conducted to more comprehensively explore the relationship between SS and FCR. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42022332718.
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Affiliation(s)
| | | | | | | | | | | | - Chaoming Hou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Gao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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