Fear Of Progression In Patients Research Articles

Current status and influencing factors of fear disease progression in Chinese primary brain tumor patients: A mixed methods study

ObjectiveIn this study, we investigated the fear of disease progression in Chinese PBT patients and examined the correlation between sociodemographic, clinical, and psychological variables of patients with the fear of progression (FoP). Additionally, the study also evaluated the subjective experience of FoP in patients with primary brain tumors (PBT). MethodsA mixed-methods study was conducted between March 2022 and December 2023, consisting of two phases: a quantitative approach in phase I, and a qualitative approach in phase II. In phase I, 305 patients with PBT filled in several questionnaires. An analysis was performed to identify potential predictors associated with FoP. In phase II, semi-structured interviews were conducted with 16 participants whose FoP scores were ≥ 34 in phase I to obtain information on their personal experiences with FoP. ResultsThe results of the quantitative study showed that 192 (63 %) patients experienced high levels of FoP. The mean score of fear of progression was (34.02±6.78). Young age, high disease uncertainty, low social support, high negative coping and low positive coping are important factors affecting FoP in PBT patients. Qualitative research focused on three themes: triggers, coping styles, and the help needed. ConclusionEnhanced screening and assessment of FoP is essential to identify dysfunctionin PBT. Meanwhile, the implications of these predictors for enhanced healthcare professional education and patient self-management may help healthcare providers implement relevant interventions promptly and help patients reduce their FoP. However, due to limitations such as sample, reporting bias, and specific mechanisms between predictors and FOPs that have not yet been explored in depth, further exploration is needed in the future.

A qualitative exploration of fear of progression in patients with nasopharyngeal carcinoma treated with proton and heavy ion therapy.

To investigate fear of progression (FOP) in nasopharyngeal carcinoma (NPC) patients treated with proton and heavy ion therapy. 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. 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. 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.

Implementation study of a novel brief clinician intervention to reduce fear of recurrence in cancer survivors (CIFeR_2 Implementation Study).

e24183 Background: Fear of cancer recurrence (FCR) is prevalent, persistent and a common unmet need. Patients indicate desire to discuss FCR with their oncologists, however most clinicians are not trained to manage FCR. Our team developed a novel clinician-driven educational intervention to help patients manage FCR (the Clinician Intervention to Reduce Fear of Recurrence (CIFeR) intervention). In earlier work, we demonstrated the feasibility, acceptability, and efficacy of CIFeR in reducing FCR in breast cancer patients.1 This study aimed to explore the barriers and facilitators to implementing this low-cost brief intervention within routine oncology practice. Methods: This multicentre, single-arm Phase I/II implementation study recruited medical/radiation oncologists and surgeons who treat women with early-stage breast cancer. Participants completed online CIFeR training on importance of doctor-lead discussions and 5 steps on how to discuss FCR with video demonstration. Participants then incorporated CIFeR in consultations with suitable patients for the next 6 months. Questionnaires were administered at baseline (T1), immediately post-training (T2), then 3 month (T3) and 6 month (T4) after training to assess confidence addressing FCR and implementation outcomes. The primary outcome of CIFeR_2 was adoption (percentage of clinicians who offer CIFeR to at least one patient in routine practice within 3-months after training). Secondary outcomes were clinician self-efficacy in FCR management, perceived acceptability, feasibility, costs, barriers and facilitators of implementation. Results: 52 clinicians (30 medical oncologists, 13 radiation oncologists and 9 surgeons) consented to the study, of whom 35 completed CIFeR training and T2 questionnaires and 28/31 completed T3 and 20/24 completed T4 questionnaires. Mean age was 43±8.6, 75% were female. CIFeR was adopted by 86% of participants, and was utilised on average 4 (range 0-10) times by trained clinicians by T3. Participants reported CIFeR taking on average 7 minutes (range 2-15min) to deliver. CIFeR was deemed acceptable, appropriate and feasibile by participants at T3. Self-efficacy in managing FCR improved significantly across all domains from T1 to T2 (n = 35, p < 0.001). Perceived difficulty with managing FCR decreased from 2.5 to 2.1 (p = 0.009) from T1-T3. Lack of time was the greatest barrier to CIFeR_2 implementation. Conclusions: A structured brief, low-cost clinician intervention to reduce FCR is useful, acceptable and improved self-efficacy with FCR management in clinicians. FCR training should be incorporated in communication skills training of oncologists and surgeons. CIFeR is currently being adapted to address fear of progression in patients with advanced cancer. Liu J, et al (2021) JCO Oncology Practice 17(6):e774-784. Clinical trial information: ACTRN12621001697875 .

The relationship between symptom perception and fear of progression in patients with chronic heart failure: a multiple mediation analysis.

Studies have shown that symptom perception is associated with fear of progression (FOP) in many diseases and regulated by psychological factors. Whether the association also occurs in patients with chronic heart failure (HF) remains unclear, as do the specific mechanisms involved. This study aimed to explore the multiple mediation effects of self-care confidence and mental resilience on the relationship between symptom perception and FOP in Chinese patients with chronic HF. A cross-sectional study was conducted on 247 patients with chronic HF recruited from two hospitals in Yangzhou, China. The sociodemographic and clinical data and self-reported questionnaires including heart failure somatic perception, fear of progression, self-care confidence, and mental resilience were collected. Data analysis relating to correlations and mediating effects was carried out by SPSS 26.0 and PROCESS v3.3 macro. Fear of progression was positively correlated with symptom perception (r = 0.599, P < 0.01), but negatively correlated with self-care confidence (r = -0.663, P < 0.01), mental resilience-strength (r = -0.521, P < 0.01), and mental resilience-toughness (r = -0.596, P < 0.01). The relationship between symptom perception and FOP was mediated by self-care confidence [effect = 0.095, 95% confidence interval (CI) (0.054-0.142)] and mental resilience-toughness [effect = 0.033, 95% CI (0.006-0.074)], respectively, and together in serial [effect = 0.028, 95% CI (0.011-0.050)]. The proportion of the mediating effect accounting for the total effect was 31.0%. Self-care confidence and mental resilience-toughness were multiple mediators of the association between symptom perception and FOP in patients with chronic HF. Interventions targeted at strengthening self-care confidence and mental resilience may be beneficial for the reduction of FOP, especially with regard to toughness.

Effectiveness of interprofessional communication skills training for oncology teams: study protocol for a three-arm cluster randomised trial (KommRhein Interpro)

IntroductionPatient–provider communication is an important factor influencing the quality of care in oncology. The study examines the comparative effectiveness of a 10-hour interprofessional communication skills training (CST) programme for physicians...

Fear of progression in patients with mild or common type COVID-19.

AimTo investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19.BackgroundAt the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored.MethodsDuring February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors.ResultsThe fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression.ConclusionWith a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning.

Association Between Daily Worry, Pathological Worry, and Fear of Progression in Patients With Cancer.

Background: Fear of progression (FoP), or fear of cancer recurrence (FCR), is characterized by worries or concerns about negative illness-related future events. Actually, to worry is a common cognitive process that, in its non-pathological form, belongs to daily life. However, worry can also become pathological appearing as a symptom of mental disorders. This study aimed at investigating the associations among daily worry, pathological worry, and FoP in patients with cancer.Methods: This is a cross-sectional study that includes 328 hospitalized patients with cancer. Patients filled out the FoP Questionnaire (FoP-Q), the Worry Domains Questionnaire (WDQ) for the assessment of daily worry, and the Penn State Worry Questionnaire (PSWQ) for the assessment of pathological worry. Depressive, anxiety, and somatic symptoms were measured with modules of the Patient Health Questionnaire [Patient Health Questionnaire-Depressive Symptoms (PHQ-2), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-Somatic Symptoms (PHQ-15)]. Furthermore, a structured clinical interview was conducted for the assessment of anxiety disorders. The hierarchical multiple linear regression analysis was used to identify factors independently associated with FoP.Results: Mean age of the participants was M = 58.5 years (SD = 12.8), and 64.6% were men. FoP and worry were significantly intercorrelated (r = 0.58–0.78). The level of FoP was most strongly associated with daily worry (β = 0.514, p < 0.001), followed by pathological worry (β = 0.221, p < 0.001). Further significant determinants were younger age and depressive and anxiety symptoms. Clinical variables were not independently associated with FoP. The final model explained 74% of the variance.Discussion: Fear of progression is strongly associated with daily worry and pathological worry. These results bring up the question of whether FoP is an expression of a general tendency to worry. Whether a general tendency to worry, in fact, represents an independent vulnerability factor for experiencing FCR/FoP needs to be investigated in a longitudinal research design.

Fear of progression in patients with new diagnosed brain tumours and their caregivers

Fear of progression in patients with new diagnosed brain tumours and their caregivers

Influencing factors of fear of progression in patients with primary liver cancer

Objective To explore the influencing factors of fear of progression in patients with primary liver cancer and to provide a basis for developing targeted intervention measures. Methods Totally 160 patients with liver cancer hospitalized in a ClassⅢ Grade A general hospital in Jilin Province were selected using convenient sampling and investigated with Fear of Progression Questionnaire-Short Form (FoP-Q-SF) . Univariate and multivariate linear regression analysis was used to analyze the influencing factors of fear of progression in the patients. Totally 160 questionnaires were distributed, and 137 valid questionnaires were collected. Results The fear of progression score of the 137 patients with liver cancer totaled (38.38±8.63) , including (20.02±5.75) in physiological health and (18.35±4.57) in the social and family dimension; multivariate linear regression analysis revealed that age, gender, Family per capita monthly income, education and whether to receive radiotherapy and chemotherapy were the factors affecting the fear of progression in the patients with liver cancer. Conclusions The patients with liver cancer show severe fear of progression, which is affected by multiple factors. Nurses should take targeted intervention measures based on patients' different situations so as to reduce their fear of progression. Key words: Liver neoplasms; Fear of progression; Influencing factor

Fear of progression in patients with low-risk malignant melanoma.

e21615 Fear of progression in patients with low-risk malignant melanoma Fear of cancer progression (FoP) is one of the problems most commonly reported by cancer patients and is among the most prevalent cancer-related worries in cancer survivors. FCR is highly variable in different cancer entities. Background: This study aimed to elicit the prevalence and significance of FCR in melanoma patients with low risk tumors and further to assess psychosocial and demographic factors predicting severity of FoP as well as to determine the impact of FoP on quality of life (QoL). Methods: In total, 133 patients with low-risk melanoma (pT1a) completed the short version of the Fear of Progression Questionnaire (FoP-Q-SF), the Hospital Anxiety and Depression Scale (HADS), and the EQ-5D questionnaire, as well as self-constructed questions on the socio-demographic background. Results: MeanFoP-Q-SF sum score was 30.1 points (± 8.4 points SD) and the median 29 points. Two thirds of patients deviated not more than 1 SD from the mean. Risk factors for elevated FoP were female gender (p &lt; 0.01), young age (p = 0.04) and working (p = 0.02) patients and patients with severe comorbidities (p = 0.03). Cancer in closely related persons predicted higher FoP (p &lt; 0.01). HADS anxiety scale (r = 0.49, p &lt; 0.01) and depression scale (r = 0.26, p &lt; 0.01) correlated with FoP. A negative correlation with the EQ-5D index was found (r = -0.34, p &lt; 0.01). Conclusions: As in many other malignancies,FoP is prevalent in low-risk melanoma patients and is associated with reduced QoL. Severe comorbidities, cancer in related persons, gender and income could be identified as predictors of FoP. Considerable high levels of FoP even in patients with low-risk malignancies underline the need of psychosocial support and intervention for special subgroups of melanoma patients to enable the patient to manage FoP more successfully.

Fear of progression in patients with gastrointestinal stromal tumors (GIST): Is extended lifetime related to the Sword of Damocles?

Background. Gastrointestinal stromal tumors (GIST) are rare and before 2000, patients had a dismal prognosis with a median survival of less than a year after tumor metastasis. However, the median overall survival has increased to more than five years following the introduction of imatinib and other tyrosine kinase inhibitors (TKI). Little is known about the psychosocial consequences of treatment of GIST, but this is important because patients now are treated and live for longer. This cross-sectional study assessed quality of life, distress, and fear of cancer recurrence or progression in patients with GIST.Material and methods. Eighty-six patients with localized or metastatic GIST were asked to participate. Patients completed self-report questionnaires including the EORTC-Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, Impact of Event Scale, Cancer Worry Scale, and Fear of Cancer Recurrence Inventory.Results. Fifty-four patients (median age 63.3 years) completed the questionnaires, 33 (61%) of whom were receiving TKI treatment at the time of the study. Overall, the GIST patients had a good global quality of life, but 28 patients had high levels of fear of cancer recurrence/progression. This high level of fear was not related to patient- or treatment-related variables. These patients experienced significantly higher levels of psychological distress, functional impairments, and difficulty making plans for the future than did patients with lower levels of fear.Conclusions. More attention should be paid to specific cancer-related problems, such as fear of cancer recurrence/progression, in addition to general quality of life issues in patients with GIST.

Progredienzangst bei chronischen Erkrankungen

Chronically physically ill patients frequently suffer from psychological distress. The realistic fear of progression (FOP) of disease is one of the most important causes of distress in these patients. This study investigates the extent of FOP in patients with diverse diagnoses. 863 Patients answered the FOP-questionnaire, medical and sociodemographic items. Group differences were investigated with t- and F-tests. Determinants for FOP were identified by linear multiple regression. Some diagnostic subgroups differ in degree and profile of FOP. Patients with rheumatic diseases and Parkinson's disease score highest, patients with stroke or chronic peripheric vascular disease lowest in FOP total scores. Age, sex, economic situation and employment effect the level of fear of progression. Systematic studies are needed to verify the importance of FOP for patients with chronic disease and to ascertain clinical indication for psychotherapeutic support.

Group Psychotherapy of Dysfunctional Fear of Progression in Patients with Chronic Arthritis or Cancer

Background: This study investigated the effectiveness of brief psychotherapeutic group interventions in reducing dysfunctional fear of disease progression (FoP). The interventions comprised either cognitive-behavioral group therapy or supportive-experiential group therapy. We tested whether these generic interventions would prove effective in different illness types. Methods: Chronic arthritis in- patients (n = 174) and cancer in-patients (n = 174), respectively, were randomized to receive one of the two interventions. The patients provided data before intervention, at discharge, and at 3 and 12 months of follow-up. FoP was the primary outcome, secondary outcomes were anxiety, depression and quality of life. A treatment-as-usual control group provided data on the primary outcome. Results: Patients with chronic arthritis indicated higher levels of FoP than cancer patients. The results revealed that, compared with no specialized intervention, both group therapies were effective in reducing dysfunctional FoP, but only among cancer patients. The effect sizes were 0.54 (cognitive-behavioral therapy) and 0.50 (supportive experiential therapy). The interventions were not differently effective in reducing the secondary outcomes. Conclusions: Dysfunctional FoP can be effectively targeted with brief group interventions. Psychotherapeutic interventions for reducing FoP should focus on specific illness characteristics.