Fear Of Disease Progression Research Articles

Effect of Collaborative Care on Fear of Disease Progression in Multiple Sclerosis Patients: A Randomized Controlled Trial

Background: Fears about the future and uncertainty in multiple sclerosis (MS) can affect the patients’ adaptation and well-being. Objectives: This study investigated the effect of collaborative care on the fear of disease progression in MS patients. Methods: In this randomized controlled trial, patients and their main caregivers were assigned into study groups (36 in the intervention and 43 in the control group) by randomized minimization method. For the intervention group, the collaborative care model was implemented in seven sessions over nine weeks. The data were collected using the Fear of Progression Questionnaire-Short Form (FOP Q-SF). Data analysis was done using descriptive statistics, Shapiro-Wilk, chi-square, Fisher Exact, independent, and paired t-tests. Results: A near-significant difference was found between the groups after the intervention (P = 0.051). However, in intragroup comparisons, the FOP score significantly decreased in the intervention group (P = 0.001) and increased in the control group after the intervention (P = 0.001). Conclusions: Collaborative care could potentially be an effective strategy for managing FOP in patients with MS.

Exploring factors to interpretation of targeted nutrition messages for people living with multiple sclerosis

ObjectivesCurrent dietary recommendations for MS suggest following national dietary guidelines developed for the general population. The aim of this study was to explore the interpretation of MS-targeted nutrition messages. MethodsUsing the Elaboration Likelihood Model of persuasion, three nutrition messages were developed targeting the strongest evidence for MS: vitamin D, dietary fat, and dietary diversity. Semi-structured interviews including the cognitive ‘thinking-aloud’ technique were used to test the messages with adults living with MS. Data were transcribed and coded thematically. ResultsTheoretical saturation was reached by 15 interviews. The data corpus indicated three themes and seven subthemes. The data revealed that people living with MS changed their diet after MS diagnosis. Dietary change was due to uncertainty, fear of disease progression and risk of relapse. The admiration and scepticism of extremist MS diets depended on personal vulnerability and support from health care professionals. The unique MS journey appeared influential to message interpretation; driven by engagement, practicality, and credibility. ConclusionThe interpretation of targeted nutrition messages revealed that dietary changes made after diagnosis are a coping mechanism to improve sense of control and self-management. Practical implicationsThe potential psychological benefit of dietary change for MS management must be prioritised using person-centred care.

Benign or painful? The interpretation of pain and fear of progression in rheumatoid arthritis.

People with chronic pain tend to interpret ambiguous information as health-related, more so than people without. In this study, we aimed to investigate whether people with rheumatoid arthritis (RA) exhibit this interpretation bias and whether it is associated with fear of disease progression (FoP). The interpretation biases of people with RA (n = 164) were compared with an age- and gender-matched control group. We hypothesized that (1) people with RA would have larger interpretation biases than people without; (2) those who scored in the clinical range for FoP would have larger interpretation bias than those who did not; (3) interpretation bias would moderate the relationship between pain severity and FoP; and (4) interpretation bias would explain variance in FoP above and beyond other established predictors. Our results confirmed that people with RA were more likely to interpret ambiguous information as health-related compared with people without RA. This effect was more pronounced for the RA subgroup with clinically significant FoP than those scoring in the normal range. We did not find evidence to suggest interpretation bias moderated the relationship between pain and FoP or that FoP added to the variance of other known predictors. Our results indicate that interpretation bias is common amongst people with RA and is associated with FoP. Further research is required to illuminate the exact nature of this relationship.

A cross-sectional study of existential concerns and fear of progression in people with Rheumatoid Arthritis

ObjectivesPeople with rheumatoid arthritis (RA) have higher levels of fear of disease progression (FOP) than cancer survivors. In cancer, FOP is inextricably linked with existential concerns. However, this has not been investigated in people with RA. MethodsWe recruited 165 people with RA (96%F) who volunteered for a treatment trial of psychological intervention. Participants completed the Existential Concerns Questionnaire (ECQ) and questionnaires measuring constructs associated with FOP in cancer. We created groups of people with RA, with and without clinically significant levels of FOP (clinical and control groups) and compared their existential concerns. We hypothesized that existential concerns would add to the variance in FOP over and above pain, psychopathology, and disability. ResultsNearly two-thirds of people with RA scored in the clinical range for FOP. The clinical group had higher levels of all existential concerns than the control group. When subscales of the ECQ were entered into a multiple regression with FOP as the dependent variable, death anxiety, meaninglessness and guilt domains accounted for significant variance in FOP. Moreover, when added to a regression equation controlling all other variables, existential concerns continued to account for unique variance in FOP (t = 2.712, p = 0.007). ConclusionExistential concerns were strongly associated with FOP. While this cross-sectional study cannot determine whether existential concerns underlie FOP in RA, these results show robust relationships that warrant future investigation.

Understanding Alveolar echinococcosis patients' psychosocial burden and coping strategies-A qualitative interview study.

Alveolar echinococcosis (AE) is a serious parasitic zoonotic disease that resembles malignancy with clinically silent infiltrative growth predominantly involving the liver. AE patients show high levels of comorbid psychological burden and fear of disease progression. This study aimed to examine AE patients' perspective on their disease-related psychosocial burden using qualitative methods. We conducted N = 12 semi-structured interviews with AE patients focusing on their disease-related psychosocial burden, coping strategies, information seeking behavior, and subjective illness concepts. To this end, AE patients from a previous quantitative cross-sectional study were invited to participate. After verbatim transcription, interviews were analyzed thematically. After analysis, data was grouped into five main themes: A) Perceived disease-related burden, B) Coping with disease-related burden, C) Disease-related impact on their social environment, D) Facing the future with the disease, and E) Disease-related information seeking behavior and subjective illness concepts. All participants perceived AE as a severe disease with inextricably linked biological, psychological, and social effects. Key positive influences reported included the provision of information and access to informal and formal support, including the ability to lead active personal and professional lives for as long as possible. Self-directed, web-based information seeking often led to increased feelings of hopelessness and anxiety. Our findings underscore the need to consider psychosocial morbidity in AE patient management. To reduce psychological burden, address disease-related apprehensions, and to prevent stigmatization, health professionals need to provide AE patients with comprehensive disease-related information to improve patient and social awareness.

Relationship between quality of life, fear of disease progression, and coping styles in patients with pulmonary hypertension: A network analysis.

A poor quality of life (QoL) in patients with pulmonary hypertension (PH) is often associated with emotional disturbances and the ability to cope. Little is known, however, about the intrinsic links among the QoL, fear of disease progression (FoP), and coping styles in patients with PH. The purpose of this study was to elucidate the relationships among QoL, FoP, and coping styles in patients with PH. We conducted a cross-sectional survey of 247 patients from a tertiary hospital in Jinan, China and analyzed the relationships using network analysis. Participants completed the World Health Organization's Quality of Life Questionnaire, Fear of Disease Progression Questionnaire and Simple Coping Style Questionnaire during the survey period. The total QoL, positive coping, and negative coping scores were 46.55 ± 10.46, 31.75 ± 6.85, and 18.75 ± 4.66, respectively. The QoL psychological domain had the strongest centrality, deserving more attention than other domains. The coping styles were bridge nodes that connected the whole network, where negative coping and social family FoP, and positive coping and both social and psychological QoL had the strongest positive correlations. There were no significant sex-based or age-based differences in the networks. To improve QoL and psychological well-being in people with PH, healthcare professionals must focus on issues beyond the patient's physical health. Specifically, they should focus on positive coping styles, while developing interventions to promote positive coping and reduce negative coping styles.

The effect of health literacy, self-efficacy, social support and fear of disease progression on the health-related quality of life of patients with cancer in China: a structural equation model

BackgroundHealth literacy (HL), self-efficacy (SE), social support (SS) and fear of disease progression (FOP) are all important factors affecting health-related quality of life (HRQoL) in cancer patients. However, their synergistic effects and underlying mechanisms on HRQoL in cancer patients remain unclear. Therefore, the purpose of this study was to construct a structural equation model (SEM) to explore the underlying mechanism of factors affecting HRQoL. It is hoped that this study will provide a theoretical basis for future interventions.MethodsA cross-sectional design and convenience sampling method were used to investigate cancer inpatients in two general hospitals in Chongqing and Chengdu. Data were collected using structured scales, including HL, SE, SS, FOP and HRQoL. Finally, the SEM was constructed, and P ≤ 0.05 was considered significant.ResultsThere were 1749 participants included in this study. Correlation analysis showed that all variables were significantly correlated with one another except for symptoms, physical health (PD) and social family (SF) (p < 0.01). The SEM of the HRQoL had a good overall fit (GFI = 0.943, AGFI = 0.917, NFI = 0.950, RFI = 0.936, CFI = 0.955, IFI = 0.955, RMSEA = 0.072). The model indicated that HL had the strongest correlation with HRQoL (β = 0.398, p < 0.01), followed by FOP (β = -0.364, p < 0.01), SE (β = 0.347, p < 0.01) and SS (β = 0.184, p < 0.01).ConclusionsThe HRQoL of cancer patients is correlated with HL, SS, SE and FOP. HL can directly affect HRQoL and mediate HRQoL through SS and SE. Future programs should consider HL promotion, SE improvement and SS expansion as the breakthrough point when designing targeted intervention strategies. At the same time, the importance of the impact of FOP on the HRQoL of patients with cancer should not be ignored.

PCR213 Fear of Progression in Multiple Sclerosis: Evaluation of Existing Patient-Reported Outcomes (PRO) Instruments

Multiple sclerosis (MS) is a chronic, progressive disease characterized by debilitating symptoms and causes great psychological and emotional distress. While fear of disease progression (FoP) has been widely assessed in oncology and other chronic conditions, FoP has been less studied in MS and prevalence of suitable patient reported outcomes (PRO) is unclear. This study aimed to identify existing instruments that have been used to measure FoP, and related concepts, in people with MS (PwMS).

Relationship between the burden of care and fear of disease progression in mothers of children with cystic fibrosis

Objectives: Aim of this study was determining the relationship between burden of care and fear of disease progression in mothers of children with cystic fibrosis. Methodology: 142 mothers of children with cystic fibrosis (CF) participated in this correlational study. Data were collected with sequential method. The researchers employed the self-report Zarit burden of care and fear of disease progression questionnaire in parents of children with CF. Mothers answered the questioners separately. Data were analyzed with statistical analysis of variance and independent t-test. Results: According to the results, the mean maternal burden of care was 34.12 ± 69.77, and the mean fear of disease progression was 32.12 ± 92.11. The burden of care had the highest regression effect on fear of disease progression in mothers of children with CF (β = 0.896). With an increase of one unit of standard deviation in the burden of care, an increase of 0.896 units occurred in fear of disease progression in parents of children with CF. Conclusion: Mothers of children with CF experience a moderate burden of care and fear of disease progression. An increase in the burden of care and psychological stress increases the fear of disease progression in these mothers.

Psychosocial Aspects of Living Long Term with Advanced Cancer and Ongoing Systemic Treatment: A Scoping Review.

Simple SummaryAn emerging group of advanced cancer patients are living long term on systemic treatment. However, studies examining the psychosocial impact of this prolonged cancer treatment trajectory are scarce. This scoping review summarizes findings on these psychosocial issues, as well as the terminology used to refer to these patients. Prominent psychosocial outcomes included uncertainty, anxiety, and fear of disease progression or death, hope, loss and worries about loved ones and changes in social life. These themes were not extensively investigated in research using validated psychological questionnaires. More quantitative research in this area should be conducted to further understand these psychological constructs. A large variety of terms used to refer to the patient group was observed, which calls for a uniform definition to better address this specific patient group in research and in practice. By identifying key themes and gaps in the literature, directions for future research and clinical practice can be provided.(1) Background: Studies examining the psychosocial impact of living long term on systemic treatment in advanced cancer patients are scarce. This scoping review aimed to answer the research question “What has been reported about psychosocial factors among patients living with advanced cancer receiving life-long systemic treatment?”, by synthesizing psychosocial data, and evaluating the terminology used to address these patients; (2) Methods: This scoping review was conducted following the five stages of the framework of Arksey and O’Malley (2005); (3) Results: 141 articles published between 2000 and 2021 (69% after 2015) were included. A large variety of terms referring to the patient group was observed. Synthesizing qualitative studies identified ongoing uncertainty, anxiety and fear of disease progression or death, hope in treatment results and new treatment options, loss in several aspects of life, and worries about the impact of disease on loved ones and changes in social life to be prominent psychosocial themes. Of 82 quantitative studies included in the review, 76% examined quality of life, 46% fear of disease progression or death, 26% distress or depression, and 4% hope, while few studies reported on adaptation or cognitive aspects. No quantitative studies focused on uncertainty, loss, or social impact; (4) Conclusion and clinical implications: Prominent psychosocial themes reported in qualitative studies were not included in quantitative research using specific validated questionnaires. More robust studies using quantitative research designs should be conducted to further understand these psychological constructs. Furthermore, the diversity of terminology found in the literature calls for a uniform definition to better address this specific patient group in research and in practice.

Correlates of Fear of Cancer Progression during COVID-19 in Romania

Objectives. Fear of cancer progression (FoP) is one of patients’ greatest concerns and one of the most reported unmet needs. Higher levels of FoP can negatively impact a patient’s quality of life, impairing physical, emotional, social and functional well-being. The Romanian health-care system has difficulties in offering qualitative psychosocial assistance for cancer outpatients. Due to their specific implications, the COVID-19 pandemic restrictions might further affect FoP, therefore our objective was to investigate correlates of FoP in cancer outpatients during the COVID-19 pandemic in Romania. Material and methods. The study investigated correlates of FoP in 330 Romanian cancer outpatients assessed during 2021. T-tests, Multivariate General Linear Models and Hierarchical Regression Models were conducted in order to assess the relationship between variables. Outcomes. Results showed differences in the assessed variables depending on gender (women had scores significantly higher than men regarding FoP and illness intrusiveness) and marital status. Moreover, using a hierarchical regression model, we identified three statistically significant predictors of FoP: gender, illness intrusiveness regarding relationships and anxiety, together explaining 38.2% of the variance in global FoP scores. Anxiety was the most important predictor of FoP, explaining 21.3% of the variance in the FoP scores, 5 times more than gender and almost 2 times more than illness intrusiveness in interpersonal relationships. Conclusions. Cancer is a complex experience, impacted by both socio-demographic variables such as gender and marital status, as well as psychological variables such as anxiety and fear of disease progression. Individualized psychosocial-care should be recognized as essential, and personalized interventions should be integrated into the patient's treatment plan.

Correlation research between fear of disease progression and quality of life in patients with lung cancer.

Lung cancer has the highest incidence rate and mortality rate of all malignancies. In recent years, the therapeutic effect of lung cancer has been greatly improved, but the fear of disease progression still directly affects the quality of life (QOL) of patients. The aim of this study was to evaluate the factors affecting the progression of fear of disease and its impact on the quality of life in patients with lung cancer. From December 2019 to February 2020, 102 patients with lung cancer in the Department of Thoracic Oncology of a top three hospital were investigated by using the simplified fear of disease progression scale (FoP-Q-SF) and the quality-of-life scale for cancer patients (FACT-G). Data were collected and statistically analyzed by SPSS25.0 software. A total of 110 questionnaires were distributed and 102 valid questionnaires were recovered, indicating a recovery rate of 92.7%. The results of multiple stepwise regression analyses showed that blood group, monthly income, and mood state were the influencing factors for the progression of phobic diseases in cancer patients (P<0.05), and the score of progression of phobic disease was negatively correlated with the quality-of-life score (r=-0.382). The progress of phobic diseases in patients with lung cancer seriously affects their QOL, and further attention by medical staff in providing health education, psychological counseling, social support, and other measures is required.

Anxiety and depressive disorders in cystic fibrosis (review)

Anxiety and depressive disorders aspects are considered in the article, as well as their prevalence among cystic fi-brosis patients. Epidemiologic data show that over 20% population suffer from at least one of these disorders (anxiety or depression) during lifespan. Pathogenet-ic aspects of anxiety and depression development are addressed. Among adult CF patients, 5.6–19% had de-pression indicators according to HADS scale and 33.4% according to PHQ-9. Significant negative correlation was found between depression and lung function (r=–0.39, р=0.01), anxiety and lung function (r=–0.36, р=0.02). In-creased depression symptoms were detected in 10% of adolescents, in 37% cases of mothers and 31% fathers pa-tients with CF; anxiety symptoms — in 22% сases of ado-lescents, in 32% of adults with CF, and in 48% of mothers and 36% of fathers of CF patients; on the whole, 2-3 times higher than in general population. Treating depression and anxiety syndrome in CF patients should include cog-nitive-behaviour therapy and psychotherapy. Examina-tion of parents of CF patients after cognitive-behaviour therapy demonstrated significant decrease of anxiety symptoms (approximately by 5 points, from heightened to normal levels). Fear of disease progression (p&lt;0.001) and depression symptoms (p=0.02) also decreased sig-nificantly, quality of life indicators related to health im-proved (p=0.01). The result was preserved at control as-sessment after 3 months. Conclusion. Today, we do not have sufficient data about psychological interventions to support cystic fibrosis patients and their caregivers. Psy-chologic interventions should aim specific symptoms of the disease or behavior connecting with diseases

Attitude towards the disease and quality of life of patients with multiple sclerosis as a target of personalized psychotherapy for PTSD

Attitude towards the disease and quality of life of patients with multiple sclerosis as a target of personalized psychotherapy for PTSDA chronic, progressive, potentially disabling disease with a poor prognosis can trigger the development of post-traumatic stress disorder (PTSD). The article presents the results of a survey of 127 patients with multiple sclerosis (MS), of which 61 patients had PTSD symptoms that developed in connection with the underlying disease were verified. The control group included 67 patients with MS who were resistant to stress. To fulfill the objectives of the study, all patients underwent a thorough collection of anamnestic information. To study the structure of the internal picture of the disease, we used a test technique aimed at diagnosing the type of attitude toward the disease (TOBOL). The study of QOL indicators was carried out using the SF-36 questionnaire.To assess the cognitive, emotional and behavioral aspects of anxiety about progression, the following questionnaires were used: “A short questionnaire for assessing the fear of disease progression” A. Mehnert, P. Herschbach, P. Berg (2006), adapted by N.А. Sirota, D.V. Moskovchenko (2014) and “Questionnaire of cognitive ideas about the disease” A. Evers, F. Kraaimaat (1998), adapted by N.A. Sirota, D.V. Moskovchenko (2014). As a result of the study, it was revealed that the patients of the main group have significantly lower scores of both physical and mental functioning when assessing the quality of life. At the same time, patients with PTSD are characterized by a higher intensity of anxiety about progression, negative thinking, and emotional reactions associated with the disease. An inadequate internal picture of the disease, characterized by the presence of mental maladjustment due to the disease, prevails in the group of patients with PTSD. All of these factors can be predictors of the development of PTSD. It is necessary to conduct further studies of the psychological characteristics of this group of patients in order to identify the targets of psychotherapeutic influence.

Impact of COVID-19 in gynaecological oncology care: a systematic rapid review.

PurposeSynthesis of available evidence on clinical practice in gynaecological oncology during the COVID-19 pandemic is highly warranted, as women with cancer are at increased risk due to their systemic immunosuppressed state and changes in their care are inevitable. Rapid review of available data is a quick way of providing useful information and insight into the way medical practice has been affected by the COVID pandemic.MethodsWe conducted a systematic rapid review, based on a literature search of MEDLINE/PubMed, Embase, and Cochrane CENTRAL. We considered all studies on gynaecological oncology care during the COVID-19 pandemic using relevant keywords and MeSH terms. Selection criteria were English language, studies with more than five cases and publication in peer-review journal.ResultsNine retrospective studies, one systematic review and five questionnaire surveys were included. Quality of the studies has been assessed. Development of higher quality evidence is warranted. Mortality of COVID-19 infection is higher in patients with gynaecological cancer than in non-cancer patients. Reported delays in diagnosis and management of cancer and changes in treatments, may affect the natural history of cancer and increase patients’ anxiety and fear of disease progression while causing concerns to healthcare professionals affecting their clinical practice. The number of new diagnoses has declined. Prioritization is important, face-to-face interactions should be limited, and appropriate protective measures are essential. Cancer surgery, chemotherapy, and radiotherapy should continue as high priority practices.ConclusionThe COVID-19 pandemic has affected clinical practice significantly. Adaptations in clinical practice may improve mortality and complication rates.

Involving patients' perspective in the development of an internet- and mobile-based CBT intervention for adolescents with chronic medical conditions: Findings from a qualitative study

ObjectiveA user-centered approach is critical for increasing the adherence to and effectiveness of an internet- and mobile-based intervention program. Therefore, potential future intervention users were involved in the development of an internet- and mobile-based cognitive behavioral therapy program (iCBT) for adolescents and young adults (AYA) with chronic medical conditions and comorbid symptoms of anxiety or depression. We aimed to identify challenges and coping strategies of the intended target group, as well as their needs and preferred intervention characteristics for an iCBT program. MethodsTwenty AYA (aged 14–20, 60% females) with either type 1 diabetes (55%), juvenile idiopathic arthritis (25%) or cystic fibrosis (20%) were interviewed in condition-specific focus groups (4–11 participants per group) either via videoconferencing or face-to-face. Transcript verbatim data was analyzed using content analysis. ResultsFrequently reported disease-specific burdens were among others fear of disease progression, non-acceptance of disease and stressful incidents related to and aversions against medical therapy. Most frequently reported coping strategies included, seeking social support and accepting the disease. Recommendations for the content of an iCBT for comorbid symptoms of anxiety and depression comprised: dealing with disease-related fears and getting advice on health-promoting lifestyles. iCBT characteristics considered preferable by participants were: providing individual feedback by a real-person; implementation of a feature to monitor treatment progress; youthful and varied content presentation; time per session not exceeding 1 h; non-involvement of parents. A mobile-based reminder feature was considered useful, and individual tailoring and self-determination of iCBT content was considered desirable. ConclusionsThe findings highlight important patient perspectives and age-specific recommendations which can help design more optimal iCBT interventions for AYA with chronic medical conditions.

Depression, Rather Than Cancer-Related Fatigue or Insomnia, Decreased the Quality of Life of Cancer Patients

PurposeCancer-related fatigue is a common and distressing symptom that occurs during cancer treatment. This study aimed to find factors that are related to cancer-related fatigue, and its effect on patients’ quality of life.Materials and MethodsThis study included 159 patients who completed questionnaires and interviews during their initial examination at the sleep clinic for cancer patients, Asan Medical Center, between December 2018 and January 2020. Their medical reports were reviewed retrospectively. Questionnaire data about depression, anxiety, insomnia, fear of disease progression, and dysfunctional beliefs about sleep, pain, and quality of life, were reviewed. Additionally, patient sleep structure data were analyzed.ResultsFactors such as depression (p < 0.001), anxiety (p < 0.001), fear of cancer progression (p < 0.001), fatigue (p=0.027), and time in bed during 24 hours (p=0.037) were significant expecting variables for low quality of life from logistic regression analysis. In pathway analysis, depression (p < 0.001), not cancer-related fatigue (p=0.537), act as a direct risk factor on quality of life. And also, depression was an overall risk factor for insomnia, fatigue, and daily activity of cancer patients.ConclusionCancer-related fatigue did not show significant effect on patient’s quality of life in this study. However, the result of pathway analysis highlights the importance of assessing depression in the process of cancer treatment and providing appropriate interventions.

Fear of disease progression and relevant correlates in acute leukemia patients prior to allogeneic hematopoietic stem cell transplantation.

Prior to hematopoietic stem cell transplantation (HSCT), and despite the high objective risks associated with HSCT, fear of progression (FoP) has only sparsely been studied in patients with acute leukemia until now. The aim of this study was the assessment of the prevalence of FoP, and any relevant correlates and typical concerns. We included 59 adult patients with acute leukemia who were tested prior to their first HSCT during an in-patient stay. Patients completed self-report measures assessing FoP (Fear of Progression Questionnaire-Short Form, FoP-Q-SF) and relevant correlates of FoP (eg, patients' physical state, depression, psychosocial distress, or social support). About one third of the patients (35.6%; n = 21) had high FoP. Higher FoP was associated with previous cancer diagnosis, as well as depression, anxiety, reduced physical functioning, lower mental health-related quality of life, and lower positive social support. The greatest fears reported by these patients reflected common fears of cancer patients (eg, fear about leaving their families behind), but also specific fears related to the current situation (eg, fear of severe medical treatments during the course of the illness). This was the first study providing an extensive analysis of FoP in leukemia patients prior to the extreme situation of HSCT. FoP is frequent and of major clinical importance for these patients. Hence, we recommend that patients undergo routine screening for FoP, to identify highly distressed patients at an early stage, and to offer targeted support.

Social impacts of living with chronic hepatitis B in South Sudanese community in Australia

ABSTRACT Introduction: Chronic hepatitis B presents significant issues to public health and clinical practices. The infection requires lifelong clinical management and is a leading risk factor for liver cancer and liver cirrhosis. Limited studies currently exist on the social impacts of living with chronic hepatitis B, especially for people from Sub-Saharan Africa. The current study explored the experiences of South Sudanese people living with chronic hepatitis B in Australia. Methods: A qualitative inquiry using face-to-face interviews with fifteen South Sudanese people with chronic hepatitis B in Australia explored the social impacts of living with chronic hepatitis B. The study purposively sampled participants who self-identified as South Sudanese with hepatitis B and over 18 years of age. Interviews were coded and analysed using thematic analysis. Results: The study identified three themes relating to the experiences of living with chronic hepatitis B, and were grouped into psychological, interpersonal and healthcare system levels. Psychological level experiences related to the uncertainty of living with chronic hepatitis B and liver cancer risk, where participants expressed persistent fear of disease progression and anxiety around death related to the disease. Interpersonal level experiences involved the disclosure of hepatitis B and its social impacts including stigma, social distancing and isolation. Healthcare system level experiences included receiving mixed messages about hepatitis B, challenges with regular testing and difficulty receiving hepatitis B treatment. Conclusion: The findings provide valuable insights into the social impacts of hepatitis B. It underlines the importance of integrated public health interventions at the community level to improve knowledge and awareness of hepatitis B which address stigma in the South Sudanese community in Australia.

Research on the Progress and Influencing Factors of Fear Disease in Patients with Bladder Cancer after Operation

To understand the status of fear disease progression in patients with bladder cancer after intravesical instillation chemotherapy and to analyze the influencing factors, so as to provide reference for psychological nursing. Methods A questionnaire survey was conducted on 110 patients with bladder cancer after the first bladder infusion chemotherapy using general questionnaire, fear disease progression simplification scale and simple disease perception questionnaire. Results The total score of patients with fear disease progressed (25.31±5.35), 7.27% of patients showed psychological dysfunction; multiple regression analysis showed disease perception, tumor recurrence, tumor histological grade, gender, age was the influencing factor of fear disease progression in patients with bladder cancer after intravesical instillation chemotherapy (P<0.05, P<0.01). Conclusion Patients with intravesical instillation chemotherapy after bladder cancer have fear of disease progression. Women who need to focus on women, recurrence and high histological grade can im-prove the level of fear disease progression by improving disease perception.