Predictors and Patterns of Fear of Cancer Recurrence in Breast Cancer Survivors
Predictors and Patterns of Fear of Cancer Recurrence in Breast Cancer Survivors
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DOI：
10.1037/hea0000238
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发表时间：
2016-01-01
影响因子：
4.2
通讯作者：
Jacobsen, Paul B.
中科院分区：
文献类型：
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作者：
McGinty, Heather L.;Small, Brent J.;Jacobsen, Paul B.
目的：这项前瞻性、纵向研究考察了接受乳房x光检查的乳腺癌幸存者对癌症复发的恐惧（FCR）。假设FCR在乳房x光检查前增加，从乳房x光检查前立即下降到乳房x光检查后立即下降，结果为阴性，然后在乳房x光检查后增加。还研究了可能存在的不同的FCR轨迹。基于健康焦虑的认知-行为模型（CBM），假设在所有研究时间点上，较高的复发风险感知、较差的复发后果感知、较低的治疗疗效信念、较低的应对自我效能和更多的寻求安慰行为参与与较高的FCR相关。方法：在0-IIIA期乳腺癌治疗结束后，161名女性完成了以下测量：复发的感知风险和感知后果、治疗效果信念、应对自我效能感和寻求安慰行为。参与者报告了乳房x光检查前后3个时间点的FCR。生长曲线分析用于测试FCR随时间的变化，生长混合模型检查了FCR的不同轨迹以及CBM预测这些轨迹的能力。结果：正如假设的那样，FCR随时间显著改变；评分在乳房x光检查前增加，在收到乳房x光检查阴性结果后立即下降，在乳房x光检查后的一个月内增加。生长混合模型显示了CBM预测的高fcr和低fcr 2类。结论：这些研究结果支持使用CBM来预测哪些癌症幸存者经历更大的FCR，并表明CBM驱动的干预可能有助于减少令人痛苦的FCR。
Objective: This prospective, longitudinal study examined fear of cancer recurrence (FCR) among breast cancer survivors having mammograms. FCR was hypothesized to increase prior to the mammogram, decrease from immediately pre- to immediately post-mammogram with negative results, and then increase following the mammogram. The possible presence of different trajectories of FCR was also examined. Based on the cognitive-behavioral model (CBM) of health anxiety, greater perceived risk of recurrence, worse perceived consequences of recurrence, lower treatment efficacy beliefs, lower coping self-efficacy, and more engagement in reassurance-seeking behaviors were hypothesized to be associated with greater FCR across all study time points. Methods: Following treatment completion for Stage 0-IIIA breast cancer, 161 women completed the following measures: perceived risk and perceived consequences of recurrence, treatment efficacy beliefs, coping self-efficacy, and reassurance-seeking behaviors. Participants reported FCR at 3 time points before and 3 after the mammogram. Growth curve analysis was used to test for changes in FCR over time and growth mixture modeling examined different trajectories in FCR and the ability of the CBM to predict these trajectories. Results: As hypothesized, FCR significantly changed over time; scores increased prior to the mammogram, decreased immediately following receipt of negative mammography results, and increased during the month following the mammogram. Growth mixture models revealed 2 classes, higher-FCR and lower-FCR, which were predicted by the CBM. Conclusions: These study findings support the use of the CBM in predicting which cancer survivors experience greater FCR and indicates that CBM-driven interventions may prove beneficial for reducing distressing FCR.