Fear of Cancer Recurrence: A Model Examination of Physical Symptoms, Emotional Distress, and Health Behavior Change.

Q1 Nursing
Journal of Oncology Practice Pub Date : 2019-09-01 Epub Date: 2019-07-12 DOI:10.1200/JOP.18.00787
Daniel L Hall, Rachel B Jimenez, Giselle K Perez, Julia Rabin, Katharine Quain, Gloria Y Yeh, Elyse R Park, Jeffrey M Peppercorn
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引用次数: 39

Abstract

Purpose: Fear of cancer recurrence is highly prevalent among adult survivors of cancer. The role of fear of recurrence in the emotional distress of survivors of cancer, as well as health behaviors that may directly affect their health, remains unclear. To advance oncology practice, this study sought to examine the extent to which fear of recurrence stemming from physical symptoms accounts for emotional distress in a large sample of adult survivors of cancer and to extend the model to explain postdiagnosis self-reported health behavior change.

Methods: In 2016, 258 survivors of cancer at an academic hospital completed a survey of psychosocial needs. Items assessed physical symptoms (checklist), fear of cancer recurrence (Assessment of Survivor Concerns), emotional distress (anxiety and depressed mood), and health behaviors (current alcohol use, physical activity, diet, and sunscreen use, as well as changes after cancer diagnosis) informed by National Comprehensive Cancer Network survivorship guidelines. Indirect effects regression models accounting for relevant covariates (age and treatment history) used 5,000-iteration bootstrapping.

Results: Higher fear of cancer recurrence was associated with greater number of physical symptoms (P < .001), greater emotional distress (P < .05), lower moderate or vigorous physical activity (P < .05), higher sunscreen use (P < .05), and postdiagnosis increases in alcohol use (P < .01) and reductions in physical activity (P < .01). Fear of cancer recurrence models accounted for almost half of the variance in distress of survivors of cancer (R2 = 0.44, P < .001) and, to a lesser yet significant extent, changes in alcohol consumption (R2 = 0.09, P < .001) and physical activity (R2 = 0.06, P = .003).

Conclusion: Fear of cancer recurrence plays a central role in the emotional distress and key health behaviors of survivors of cancer. These findings support fear of cancer recurrence as a potential target for emotional health and health behavior change interventions.

Abstract Image

对癌症复发的恐惧:身体症状、情绪困扰和健康行为改变的模型检查。
目的:对癌症复发的恐惧在成年癌症幸存者中非常普遍。在癌症幸存者的情绪困扰以及可能直接影响其健康的健康行为中,对复发的恐惧所起的作用尚不清楚。为了推进肿瘤学实践,本研究试图在大量成年癌症幸存者样本中检查对身体症状复发的恐惧在多大程度上解释情绪困扰,并扩展该模型以解释诊断后自我报告的健康行为改变。方法:2016年,某学术医院258名癌症幸存者完成了心理社会需求调查。评估项目包括身体症状(检查表)、对癌症复发的恐惧(幸存者担忧评估)、情绪困扰(焦虑和抑郁情绪)和健康行为(目前饮酒、体育活动、饮食、防晒霜使用以及癌症诊断后的变化),这些都是根据国家综合癌症网络幸存者指南进行评估的。考虑相关协变量(年龄和治疗史)的间接效应回归模型使用5000次迭代自举。结果:对癌症复发的高度恐惧与更多的身体症状(P < 0.001)、更大的情绪困扰(P < 0.05)、更少的中度或剧烈体育活动(P < 0.05)、更多的防晒霜使用(P < 0.05)以及诊断后酒精使用增加(P < 0.01)和体育活动减少(P < 0.01)相关。对癌症复发的恐惧模型几乎占癌症幸存者痛苦方差的一半(R2 = 0.44, P < .001),在较小但显著的程度上,饮酒(R2 = 0.09, P < .001)和体育活动(R2 = 0.06, P = .003)的变化。结论:对癌症复发的恐惧在癌症幸存者的情绪困扰和关键健康行为中起着核心作用。这些发现支持对癌症复发的恐惧作为情绪健康和健康行为改变干预的潜在目标。
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来源期刊
Journal of Oncology Practice
Journal of Oncology Practice Nursing-Oncology (nursing)
CiteScore
4.60
自引率
0.00%
发文量
0
期刊介绍: Journal of Oncology Practice (JOP) provides necessary information and insights to keep oncology practice current on changes and challenges inherent in delivering quality oncology care. All content dealing with understanding the provision of care—the mechanics of practice—is the purview of JOP. JOP also addresses an expressed need of practicing physicians to have compressed, expert opinion addressing common clinical problems.
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