Trajectories of Fear of Recurrence in Women with Breast Cancer
Identifieur interne : 003950 ( Pmc/Curation ); précédent : 003949; suivant : 003951Trajectories of Fear of Recurrence in Women with Breast Cancer
Auteurs : Laura B. Dunn [États-Unis] ; Dale J. Langford [États-Unis] ; Steven M. Paul [États-Unis] ; Molly B. Berman [États-Unis] ; Dianne M. Shumay [États-Unis] ; Kord Kober [États-Unis] ; John D. Merriman [États-Unis] ; Claudia West [États-Unis] ; John M. Neuhaus [États-Unis] ; Christine Miaskowski [États-Unis]Source :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [ 0941-4355 ] ; 2014.
Abstract
Although fear of recurrence (FCR) is common among cancer survivors, it remains unclear what factors predict initial levels (e.g., prior to surgery) or changes in FCR in the post-treatment period. Among women treated for breast cancer, this study evaluated the effects of demographic, clinical, symptom, and psychosocial adjustment characteristics on the initial (preoperative) levels of FCR and trajectories of FCR over the six months following surgery.
Prior to and for six months following breast cancer surgery, 396 women were assessed for demographic and clinical (disease and treatment) characteristics, symptoms, psychological adjustment characteristics, and quality of life (QOL). FCR was assessed using a four-item subscale from the QOL instrument. Hierarchical linear modeling was used to examine changes in FCR scores and to identify predictors of inter-individual differences in preoperative FCR levels and trajectories over six months.
From before surgery to six months postoperatively, women with breast cancer showed a high degree of inter-individual variability in FCR. Preoperatively, women who lived with someone, experienced greater changes in spiritual life, had higher state anxiety, had more difficulty coping, or experienced more distress due to diagnosis or distress to family members reported higher FCR scores. Patients who reported better overall physical health and higher FCR scores at enrollment demonstrated a steeper decrease in FCR scores.
These findings highlight inter-individual heterogeneity in initial levels and changes in FCR over time among women undergoing breast cancer surgery. Further work is needed to identify women most at risk for FCR during survivorship.
Url:
DOI: 10.1007/s00520-014-2513-8
PubMed: 25524004
PubMed Central: 5469210
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">Although fear of recurrence (FCR) is common among cancer survivors, it remains unclear what factors predict initial levels (e.g., prior to surgery) or changes in FCR in the post-treatment period. Among women treated for breast cancer, this study evaluated the effects of demographic, clinical, symptom, and psychosocial adjustment characteristics on the initial (preoperative) levels of FCR and trajectories of FCR over the six months following surgery.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Prior to and for six months following breast cancer surgery, 396 women were assessed for demographic and clinical (disease and treatment) characteristics, symptoms, psychological adjustment characteristics, and quality of life (QOL). FCR was assessed using a four-item subscale from the QOL instrument. Hierarchical linear modeling was used to examine changes in FCR scores and to identify predictors of inter-individual differences in preoperative FCR levels and trajectories over six months.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">From before surgery to six months postoperatively, women with breast cancer showed a high degree of inter-individual variability in FCR. Preoperatively, women who lived with someone, experienced greater changes in spiritual life, had higher state anxiety, had more difficulty coping, or experienced more distress due to diagnosis or distress to family members reported higher FCR scores. Patients who reported better overall physical health and higher FCR scores at enrollment demonstrated a steeper decrease in FCR scores.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">These findings highlight inter-individual heterogeneity in initial levels and changes in FCR over time among women undergoing breast cancer surgery. Further work is needed to identify women most at risk for FCR during survivorship.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9302957</journal-id>
<journal-id journal-id-type="pubmed-jr-id">8479</journal-id>
<journal-id journal-id-type="nlm-ta">Support Care Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">Support Care Cancer</journal-id>
<journal-title-group><journal-title>Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</journal-title>
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<article-id pub-id-type="manuscript">NIHMS864795</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Trajectories of Fear of Recurrence in Women with Breast Cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Dunn</surname>
<given-names>Laura B.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Langford</surname>
<given-names>Dale J.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Paul</surname>
<given-names>Steven M.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Berman</surname>
<given-names>Molly B.</given-names>
</name>
<degrees>MA</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shumay</surname>
<given-names>Dianne M.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kober</surname>
<given-names>Kord</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Merriman</surname>
<given-names>John D.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>West</surname>
<given-names>Claudia</given-names>
</name>
<degrees>RN</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Neuhaus</surname>
<given-names>John M.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miaskowski</surname>
<given-names>Christine</given-names>
</name>
<degrees>RN, PhD, FAAN</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
School of Medicine, University of California, San Francisco, CA</aff>
<aff id="A2"><label>2</label>
School of Nursing, University of California, San Francisco, CA</aff>
<aff id="A3"><label>3</label>
UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA</aff>
<aff id="A4"><label>4</label>
The Wright Institute, Berkeley, CA</aff>
<aff id="A5"><label>5</label>
School of Nursing, University of Pittsburgh</aff>
<author-notes><corresp id="FN1">Address correspondence to: Laura B. Dunn, MD, Professor, Department of Psychiatry, University of California, San Francisco, 401 Parnassus, Box 0984-F, San Francisco, CA 94143-0984, Phone: 415-476-7518, Fax: 415-476-7320, <email>laura.dunn@ucsf.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>12</day>
<month>4</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>19</day>
<month>12</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>13</day>
<month>6</month>
<year>2017</year>
</pub-date>
<volume>23</volume>
<issue>7</issue>
<fpage>2033</fpage>
<lpage>2043</lpage>
<pmc-comment>elocation-id from pubmed: 10.1007/s00520-014-2513-8</pmc-comment>
<abstract><sec id="S1"><title>Purpose</title>
<p id="P1">Although fear of recurrence (FCR) is common among cancer survivors, it remains unclear what factors predict initial levels (e.g., prior to surgery) or changes in FCR in the post-treatment period. Among women treated for breast cancer, this study evaluated the effects of demographic, clinical, symptom, and psychosocial adjustment characteristics on the initial (preoperative) levels of FCR and trajectories of FCR over the six months following surgery.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Prior to and for six months following breast cancer surgery, 396 women were assessed for demographic and clinical (disease and treatment) characteristics, symptoms, psychological adjustment characteristics, and quality of life (QOL). FCR was assessed using a four-item subscale from the QOL instrument. Hierarchical linear modeling was used to examine changes in FCR scores and to identify predictors of inter-individual differences in preoperative FCR levels and trajectories over six months.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">From before surgery to six months postoperatively, women with breast cancer showed a high degree of inter-individual variability in FCR. Preoperatively, women who lived with someone, experienced greater changes in spiritual life, had higher state anxiety, had more difficulty coping, or experienced more distress due to diagnosis or distress to family members reported higher FCR scores. Patients who reported better overall physical health and higher FCR scores at enrollment demonstrated a steeper decrease in FCR scores.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">These findings highlight inter-individual heterogeneity in initial levels and changes in FCR over time among women undergoing breast cancer surgery. Further work is needed to identify women most at risk for FCR during survivorship.</p>
</sec>
</abstract>
<kwd-group><kwd>oncology</kwd>
<kwd>breast cancer</kwd>
<kwd>fear of recurrence</kwd>
<kwd>psychological symptoms</kwd>
<kwd>symptom trajectories</kwd>
<kwd>hierarchical linear modeling</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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