Fear of cancer recurrence and hope level in patients receiving surgery for non-small cell lung cancer: a study on the mediating role of social support

Fear of cancer recurrence in patients with early-stage non-small cell lung cancer: A latent profile analysis

Objective

This study aimed to identify latent profiles of fear of cancer recurrence (FCR) among patients with early-stage non-small cell lung cancer (NSCLC) and examine the associated factors.

Methods

A cross-sectional survey was conducted with 677 patients with early-stage NSCLC who underwent surgical treatment at a tier-three cancer hospital in Beijing between January 2022 and August 2023. Data collection included demographic variables and assessments using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Herth Hope Index (HHI), and Social Support Rating Scale (SSRS). Latent profile analysis was employed to classify FCR levels and identify influencing factors.

Results

Three distinct FCR profiles emerged: "low FCR" (27.6%), "moderate FCR" (66.2%), and "high FCR" (6.2%). Independent risk factors for moderate FCR included individuals aged 36-60 years (odds ratio [OR] ​= ​1.871, 95% confidence interval [CI] 1.208-2.899) and a household income below 5000 yuan (OR ​= ​1.86, 95% CI 1.059-3.267). Protective factors for moderate FCR included lower levels of education (OR ​= ​0.505, 95% CI 0.283-0.902), religious beliefs (OR ​= ​0.355, 95% CI 0.152-0.833), and smoking (OR ​= ​0.461, 95% CI 0.284-0.747). High FCR was strongly associated with being 36-60 years old, lower HHI scores (OR ​= ​11.055, 95% CI 4.441-27.522), and poor social support (OR ​= ​3.392, 95% CI 1.385-8.308).

Conclusions

FCR among patients with early-stage NSCLC can be categorized into distinct profiles, with specific demographic and psychosocial factors influencing severity. Tailored nursing interventions addressing varying FCR levels are critical to improving patient care and psychological well-being.

The Mediating Effect of Hope Level Between Social Support and Benefit Finding in Patients With Advanced Lung Cancer

BACKGROUND

As a protective factor, social support can influence benefit finding (BF) in patients with advanced lung cancer. However, the mechanism through which social support affects BF is controversial.

OBJECTIVE

To investigate the factors influencing BF in patients with advanced lung cancer and the role of hope level in mediating the relationship between social support and BF.

METHODS

This was a cross-sectional study. From September 2022 to March 2023, 286 participants completed the Social Support Rating Scale, Herth Hope Index, and Benefit Finding Scale. Data analysis included correlation analyses and multiple stepwise regression analysis; the SPSS PROCESS program was used to determine the significance of mediating effects.

RESULTS

Social support and hope level were positively associated with BF. Monthly per-capita household income, social support and hope level entered the final regression model and explained 50.7% of BF variance. Social support's direct and indirect effects on BF were significant ( P < .05), suggesting that hope level partially mediated the relationship between social support and BF.

CONCLUSION

Our findings validate a positive association between social support and BF in patients with advanced lung cancer. The hope level as a mediating variable provided the impetus for their BF.

IMPLICATIONS FOR PRACTICE

Nurses should implement necessary interventions to help patients with advanced lung cancer carry out protective resources and coping strategies to facilitate their BF.

Family resilience in patients with gynecological malignant tumors after radical hysterectomy: based on the Walsh family resilience framework

Aim

Explore and analyze the family resilience of patients with gynecological malignancies after radical hysterectomy, providing a theoretical basis for the formulation of future intervention measures.

Methods

Using a phenomenological descriptive qualitative research method, 17 patients who underwent radical surgery for gynecological malignancies were selected for semi-structured interviews. Data analysis and theme extraction were conducted using Colaizzi data analysis method and NVivo V.12.

Results

Three themes and eight sub-themes were extracted: family belief system (confront surgical challenges head-on, attribute positive significance to adversity, stay positive), family organization model (timely adjustment of family roles, family cohesion, get support and help from others), and family communication and problem solving skills (communicate to eliminate negative emotions, collaborative problem solving).

Conclusion

This study indicates that the family belief system is the solid foundation of family resilience, the family organizational pattern serves as a buffer when the family faces adversity, and positive communication and collaborative problem solving create a positive feedback loop that enhances family resilience. Future interventions could enhance patients' family resilience from the perspective of family strengths.

The relationship between spiritual well-being and fear of cancer progression in Iranian cancer patients

Introduction

This study aimed to investigate the nuanced relationship between spiritual well-being and fear of cancer progression among individuals diagnosed with cancer.

Methods

The study was conducted in 2023 and utilized a predictive cross-sectional survey. A total of 398 cancer patients were recruited using convenience sampling. The Spiritual Well-Being Scale (SWBS) and the Fear of Progression (FOP) scale were used for data collection. Data analysis was performed using SPSS version 26, AMOS, and JASP to assess the reliability of the constructs and the potential relationship between the two main variables.

Results

The mean age of the participants was 49.14 years (SD = 16.16, 95% CI: 47.55 50.74). All constructs demonstrated strong factorial validity and reliability. Simple linear regression analysis revealed that spiritual well-being significantly predicted fear of cancer progression (R 2 = 0.064, F = 27, p < 0.001).

Discussion

The findings indicated a significant relationship between spiritual well-being and fear of cancer progression. These results highlighted the interconnectedness of spiritual well-being and fear of cancer progression among cancer patients.

Scanxiety in survivors of pancreatic cancer

PURPOSE

To understand the scanxiety experience in pancreatic cancer (PC) survivors following curative surgical resection.

DESIGN

A qualitative study with a hermeneutic phenomenological approach was used.

METHODS

Eighteen PC survivors participated. Data from in-depth, semi-structured interviews were analyzed and themes emerged from systematic line-by-line coding of the interview transcripts.

FINDINGS

Two key themes emerged: 'the recurring cycle of scanxiety' and 'hope for lifelong remission'. Participants experienced similar patterns of scanxiety that impacted everyday life. Hope was an essential stabilizing component of the cancer-scan experience, and enabled participants to conceptualize a cure, despite the high likelihood of recurrent, incurable disease. A conceptual framework was developed to provide further insight.

IMPLICATIONS

Everyday life is significantly affected during times of PC surveillance scans. This study enhances our understanding of the cancer-scan experience and provides a framework to guide care.

Construction of a novel predictive model for hope level in patients with primary liver cancer from a positive psychology perspective

This study aimed to investigate the current hope levels in patients with primary liver cancer by analyzing the risk indicators of hope levels, constructing and validating a novel hope score-based predictive model. A total of 206 patients with primary liver cancer admitted to the hepato-pancreato-biliary surgery department of a tertiary hospital from October 2020 to June 2021 were included. The Herth Hope Index was utilized to assess hope levels, and based on the questionnaire results, the patients were categorized into low-hope (≤ 30 points) and high-hope (> 30 points) groups. Single-factor analysis and logistic multivariate regression analysis were conducted to explore the factors influencing hope levels in patients with primary liver cancer. A nomogram was plotted, and a risk prediction model for hope levels in these patients was developed. The predictive performance of the nomogram model was evaluated using calibration plots, the Hosmer-Lemeshow test, and other relevant assessments. Total of 206 patients participated in the questionnaire survey, with 82 patients (39.81%) categorized as belonging to the low-hope group. The results of the single-factor analysis showed statistically significant differences (all P < 0.05) in marriage status, education level, residence, occupation, family monthly income, reason for hospitalization or outpatient visit, pressure caused by the disease on the family, history of cirrhosis, and level of social support between the two groups. These variables were subsequently included in the logistic multivariate regression model. The results of the regression analysis indicated that marriage status, residence, family monthly income, and level of social support were independent risk factors. These four influencing factors were transformed into a visual predictive model, which yielded an area under the ROC curve of 0.931 (95% CI 0.899-0.963) and demonstrated model significance (Hosmer-Lemeshow test: χ2 = 4.008, P = 0.856, P > 0.05). The observed and expected values generated by the Hosmer-Lemeshow test were plotted as a scatter plot with a fitted linear trend, showing good consistency between the predictive model and actual risk. The constructed predictive model developed in this study exhibited good predictive capability for assessing the hope levels of patients with primary liver cancer. This model can assist clinical staff in rapidly identifying the psychological risk of low hope levels in patients, thereby providing valuable insights for the timely implementation of proactive management measures.

Exploring the symptoms and psychological experiences among lung cancer convalescence patients after radical lobectomy: A qualitative study

OBJECTIVE

This study aims to explore the symptom experiences and psychological feelings of lung cancer patients after radical lobectomy in China.

METHODS

A qualitative study was conducted using face-to-face semistructured interviews with lung cancer patients who had a radical lobectomy for treatment of their cancer during the convalescence period. Participants (n = 18) were recruited from a general hospital in China, and patients were selected using purposive sampling from September 2021 to February 2022. Interviews were recorded and transcribed verbatim, and Colaizzi's seven-step method of phenomenology was used. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was conducted to report the study.

RESULTS

Four themes were extracted from the interview data: physiological dimensions (fatigue, cough or sputum, chest tightness and shortness of breath, daily activities affected, sleep disturbance, lack of appetite); psychological dimensions (negative emotion, fear of cancer recurrence, learning to accept reality, strengthened faith and hope); family dimensions (heavy economic burden, perceived family care, improved health management behavior); and social dimensions (perceived support of medical staff, decreased sense of social value and self-identity, changes in social and working style).

CONCLUSION

Lung cancer patients are still troubled by many problems during the postoperative recovery period. Medical staff should design and implement effective evaluations and targeted interventions for patients' physical and mental health as soon as possible to improve patients' physical and mental health, as well as their quality of life.

Stigma and related influencing factors in brain cancer patients: a cross-sectional study and parallel mediation analysis

PURPOSE

Patients with brain cancer and painful symptoms of the disease experience heavy pressure and negative inner experiences, leading to a sense of stigma. Therefore, this study assessed the level of stigma in patients with brain cancer and analyzed the risk factors for stigma to analyze the underlying relationships among depression, social support, low self-esteem, and stigma.

METHODS

Patients completed the Social Impact Scale, Self-rating Depression Scale, Rosenberg Self-Esteem Scale, Herth Hope Index, Social Support Rating Scale, and Self-Perceived Burden Scale. Multiple linear regression analysis was used to identify factors independently associated with stigma. Parallel mediation analysis was used to evaluate the mediating role of the relationship between psychoemotional factors and stigma.

RESULTS

A multivariate linear regression analysis demonstrated significant associations between age (β =  - 0.189, P = 0.002), treatment (β = 0.184, P = 0.003), self-esteem (β =  - 0.128, P = 0.046), depression (β = 0.273, P < 0.001), hope (β =  - 0.217, P = 0.003), and self-perceived burden (β = 0.260, P < 0.001) with brain cancer. It was observed that the social support received by brain cancer patients directly impacted their stigma (total effect, - 0.851, P = 0.001). Additionally, this relationship was influenced by depression and self-esteem through two distinct pathways.

CONCLUSION

Increased stigma among brain cancer patients was found to be associated with severe depression, feelings of inferiority, diminished hope, and a heavy perceived burden. The structural equation modeling (SEM) revealed that social support negatively influenced stigma through depression and self-esteem. It is imperative to grasp patients' inner needs, implement psychological interventions, and cultivate a cancer-friendly social environment to prevent stigmatization and discrimination based on their patient status.

Fear of disease progression, self-management efficacy, and family functioning in patients with breast cancer: a cross-sectional relationship study

Introduction

Fear of disease progression (FoP) has been identified as one of the most prevalent unmet needs among breast cancer patients in recent years. The aim of this study was to examine FoP in patients with breast cancer and explore its associations with demographic and clinical characteristics, self-management efficacy, and family functioning. We also aimed to create a clinically-relevant prediction model based off of these factors (i.e., a "nomogram") to help identify patients' probability of experiencing high FoP.

Methods

A cross-sectional survey of breast cancer in patients at the Affiliated Hospital of Jiangnan University was conducted from June 2023 to February 2024. The study included the Demographic and Clinical Characteristics Questionnaire, the Fear of Disease Progression Scale (FoP-Q-SF), the Chinese Self-Management Efficacy Scale for Cancer Patients (C-SUPPH), and the Family Care Index Questionnaire (APGAR). Data analysis included descriptive statistics, independent-samples t-test, one-way ANOVA, Pearson correlation analysis, and multiple regression analysis. A nomogram was constructed based on multiple regression results and the model performance was evaluated.

Results

A total of 151 breast cancer patients were enrolled in the study. The mean (standard deviation) FoP score of the patients was 35.87 ± 9.24. The average score of C-SUPPH was 96.97 ± 17.29, and the average score of APGAR was 6.74 ± 2.98. Pearson correlation analysis showed that FoP was negatively correlated with self-management efficacy (r = -0.544, p < 0.01) and family functioning (r = -0.730, p < 0.01). Multiple regression analysis showed that age (B = -4.038), self-management efficacy (B = -0.085) and family functioning (B = -1.972) were significantly related to FoP, and together explained 36% of FoP variation (R 2 = 0.360, F = 20.50, p < 0.001). The nomogram of these variables showed satisfactory prediction performance [the Bootstrap Correction Consistency Index (C-index) = 0.872]. According to previous studies, a C-index of >0.70 indicates that the model is acceptable.

Conclusion

We found that greater fear of cancer progression (FoP) was associated with younger age, lower self-management efficacy and poorer family functioning in breast cancer patients. Based on these variables, our exploratory prediction model should be further investigated in order to help identify breast cancer patients who may be at highest risk of experiencing high FoP.

The impact of fear of cancer recurrence on the quality of life of breast cancer patients: A longitudinal study of the mediation effect of cortisol and hope

OBJECTIVE

This longitudinal study sought to explore the impact of cortisol and hope levels on Fear of Cancer Recurrence (FCR) and Quality of Life (QOL) in a cohort of 552 breast cancer patients from three centers in Wuhan City.

METHOD

A longitudinal study involving 552 breast cancer patients from three centers in Wuhan City utilized Chinese versions of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Herth Hope Index (HHI), and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale. Cortisol levels were measured thrice daily, and data was collected longitudinally three times. Data analysis was conducted using SPSS 26.0 and Mplus 8.3, employing a longitudinal path model constructed via the cross-lagged method.

RESULTS

The results showed there were significant correlations between FCR, cortisol levels, and QOL at different time points. A significant mediating model was found with outcomes related to hope levels. Specifically, FCR predicted a decrease in hope levels (β = -0.163, p < 0.001), which in turn led to a decrease in overall QOL (β = -0.078, p < 0.001), with a mediation effect accounting for 10.34%. Although there were correlations between FCR, cortisol levels, and QOL at different time points, further analysis revealed that cortisol levels did not exhibit a mediating effect between the two (95% confidence interval: -0.002 to 0.001).

CONCLUSION

This study demonstrated there were significant correlations among FCR, QOL, and hope levels. Considering hope as a crucial mediator between FCR and QOL, potential intervention strategies for optimizing the QOL of breast cancer patients are proposed.

Trajectory of Caregiver Burden and Associated Factors in Family Caregivers of Individuals with Colorectal Cancer: A Longitudinal, Observational Multicenter Study

Purpose

To (1) investigate the changes in 5 domains (lack of family support, impact on finance, impact on daily schedule, impact on health, and self-esteem) of family caregiver (FC) burden and overall burden for first diagnosed colorectal cancer; (2) exploring changes in FC burden for colorectal cancer patients over time and analyze the trajectory and sub-trajectories of FC burden; and (3) identify the FC-related and patient-related factors most associated with the overall FC burden and each of its sub-trajectories.

Patients and methods

This study is a descriptive longitudinal study. A convenience sampling method was used to recruit patients with colorectal cancer and their primary FCs from seven hospitals.

Results

A total of 185 pairs of first diagnosed colorectal cancer patient and their FC were investigated for 4 times. The results reveal the overall burden and 5 domains of burden showed a trend of increasing first and then decreasing, and the burden was the heaviest at the time in the middle of chemotherapy. In the course of time, the aspect that caused the greatest amount of burden on average transitioned from the "effect on daily schedule" (range= 3.3 and 3.9) to the "effect on finances" (range= 3.1 to 3.4).

Conclusion

Almost 88% of FCs have a either a moderate or a high level of burden. The quality of life of patients and the self-efficacy, social support and care ability of FCs have a great impact on the overall FC burden and each sub-trajectory.

The impact of social support on benefit finding among patients with advanced lung cancer and their caregivers: based on actor-partner interdependence mediation model

PURPOSE

Advanced lung cancer and its treatment serve as a sudden stressful event that profoundly impacts the psychological experience of both the patients and their primary caregiver. This study used dyadic analyses to explore the dyadic effects of social support on benefit finding and whether hope level mediates the patient-caregiver dyads in advanced lung cancer.

METHODS

Two hundred ninety-five pairs of patients with advanced lung cancer and primary caregivers completed the Social Support Rating Scale (SSRS), the Herth Hope Index (HHI), and the Benefit Finding Scale (BFS). Dyadic analyses were conducted using structural equation modelling based on the actor-partner interdependence mediation model.

RESULTS

The results indicated that for both patients (B = 0.259, 95% CI = 0.135-0.423, P < 0.001) and their primary caregivers (B = 0.596, 95% CI = 0.403-0.838, P < 0.001), hope level mediated the actor effect of social support on benefit finding; social support was positively associated with hope level and further enhanced benefit finding. Regarding partner effects (B = 0.242, 95% CI = 0.119-0.404, P < 0.001), primary caregivers' social support significantly indirectly affected patients' benefit finding through patients' hope level.

CONCLUSION

There is an interaction between social support, hope level, and benefit finding in patients with advanced lung cancer and their primary caregivers. Healthcare professionals ought to be vigilant in recognizing patients and caregivers who are vulnerable, have limited social support, and possess diminished hope levels. At the same time, nurses should provide timely psychological support and counseling to patients and their caregivers, encourage them to actively participate in social activities, and inspire their confidence and hope in life, thus improving their benefit findings.

A latent class analysis of family resilience and its relationship with fear of recurrence in lung cancer patients: a cross-sectional study

PURPOSE

Family resilience helps cancer-affected families overcome challenges and may influence an individual's fear of cancer recurrence (FCR). Identifying distinct classes of family resilience among lung cancer patients is crucial for tailored interventions. This study aimed to identify latent classes of family resilience in lung cancer patients and explore their relationships with FCR.

METHODS

Three hundred ten lung cancer patients from three hospitals in Fujian were recruited from June to September 2021. Clinical data were extracted from medical records, while sociodemographic details, family resilience, and FCR were self-reported. A latent class analysis was performed to identify family resilience classes.

RESULTS

A 4-class solution showed the best fit. Compared to Class 1, the patients who had no comorbidities (ORs = 3.480-16.005) had an increased likelihood of belonging to Class 2 and 3, while those who were not family breadwinners (ORs = 0.118-0.176) had a decreased likelihood. Further, the patients who (1) did not lack interest/pleasure in doing things during the past 2-week period (OR = 7.057), (2) were never smokers (OR = 6.230), and (3) were urban residents (OR = 8.985) had an increased likelihood of belonging to Class 4, while those who were (1) male (OR = 0.167), (2) not the family breadwinner (OR = 0.152), and (3) had none or only one child (OR = 0.203) had a decreased likelihood of belonging to Class 4. The FCR level differed significantly among these four classes.

CONCLUSION

Our study identified four distinct classes of family resilience among Chinese lung cancer patients. FCR severity decreased with increasing levels of family resilience.

Effect of screening colonoscopy frequency on colorectal cancer mortality in patients with a family history of colorectal cancer

BACKGROUND

Colorectal cancer is a common malignant tumor in China, and its incidence in the elderly is increasing annually. Inflammatory bowel disease is a group of chronic non-specific intestinal inflammatory diseases, including ulcerative colitis and Crohn's disease.

AIM

To assess the effect of screening colonoscopy frequency on colorectal cancer mortality.

METHODS

We included the clinicopathological and follow-up data of patients with colorectal cancer who underwent laparoscopic colectomy or open colectomy at our Gastrointestinal Department between January 2019 and December 2022. Surgical indicators, oncological indicators, and survival rates were compared between the groups. The results of 104 patients who met the above criteria were extracted from the database (laparoscopic colectomy group = 63, open colectomy group = 41), and there were no statistically significant differences in the baseline data or follow-up time between the two groups.

RESULTS

Intraoperative blood loss, time to first ambulation, and time to first fluid intake were significantly lower in the laparoscopic colectomy group than in the open colectomy group. The differences in overall mortality, tumor-related mortality, and recurrence rates between the two groups were not statistically significant, and survival analysis showed that the differences in the cumulative overall survival, tumor-related survival, and cumulative recurrence-free rates between the two groups were not statistically significant.

CONCLUSION

In elderly patients with colorectal cancer, laparoscopic colectomy has better short-term outcomes than open colectomy, and laparoscopic colectomy has superior long-term survival outcomes compared with open colectomy.

Does Mandala Art Therapy Improve Psychological Well-Being of Gynecological Cancer Patients During the Perioperative Period? A Quasi-Experimental Study

BACKGROUND

Women with gynecological cancer often experience psychological distress, particularly in response to surgical procedures. The impact of mandala art therapy (MAT) during the perioperative period for gynecological cancer patients remains uncertain. We aimed to examine the effects of the MAT program in women with gynecological cancer.

METHODS

Employing a quasi-experimental design, we recruited 126 gynecological cancer patients from a university hospital through convenience sampling. Participants were assigned to either receive the MAT program or standard perioperative care. The interventions comprised a three-session MAT program guided by a team of trained mandala psychologists. Generalized estimating equations (GEE) were employed to analyze the effects of MAT over time.

RESULTS

A total of 126 patients were enrolled, and 118 completed the entire study. Over 90% of participants completed the perioperative MAT interventions, reporting relatively high satisfaction with the program (7.70 out of 10). Individuals in the MAT group exhibited improved therapeutic effects on STAI-S, VASS, and vital signs over time. Notably, significant group*time interaction effects were noted in STAI-S scores at both the first evaluation, T1 (β = -4.220, P < .005) and the third evaluation, T3 (β = -3.797, P < .05), and VASS scores at T1 (β = -11.186, P < .005), T2 (β = -9.915, P < .05) and T3 (β = -9.831, P < .05). Regarding vital signs, the multivariate GEE model revealed significant interaction effects in systolic blood pressure values at both T1 (β = -7.102, P < .05) and T3 (β = -10.051, P < .005), diastolic blood pressure values at T3 (β = -6.441, P < .005), and pulse values at T1 (β = -6.085, P < .005). No significant differences were observed between groups for pain, hope, or self-acceptance.

CONCLUSION

This study posited that MAT could serve as a valuable complementary approach in perioperative care for addressing the psychological needs of women with gynecological cancer. Subsequent research employing more robust methodologies and larger, more diverse participant samples will be necessary to validate these conclusions.

Couples' skills training intervention in young breast cancer patients with fear of cancer recurrence: A randomized controlled trial

PURPOSE

This study adapted the Chinese version of the Couple Skills Training intervention program to couples of young breast cancer patients in China and investigated its effects on fear of cancer recurrence (FCR), cancer-related communication, and level of hope among the couples.

METHODS

Ninety young breast cancer patients and their spouses were recruited and randomly assigned to the intervention group (45 couples) and the control group (45 couples). Couples in the intervention group received skills training and were assessed at baseline, post-intervention, and 3 months post-intervention to measure outcomes. Differences in scores between the two groups were analyzed using two-sample t-tests and generalized estimating equations (GEE) controlling for demographic and health-related variables.

RESULTS

Couples' skills training intervention effectively reduced FCR and improved cancer-related communication in young breast cancer patients compared to the control group (both p < 0.001). Spouses' expectations significantly increased (p < 0.001). At 3 months post-intervention, couples in the intervention group showed significant improvements in FCR, cancer-related communication, and hope (all p < 0.001).

CONCLUSION

Couples' skills training interventions are beneficial for helping young breast cancer patients cope with FCR. Couples-based interventions play a crucial role in addressing FCR in these patients and their spouses. Future research should consider larger samples and longer follow-up periods to enhance intervention effectiveness.

CLINICAL TRIAL CENTER REGISTRATION NUMBER

This study has also been registered with the Chinese Clinical Trial Registry (No: ChiCTR2200063327).

Familial aspects of fear of cancer recurrence: current insights and knowledge gaps

Fear of cancer recurrence is fear or worry about cancer recurrence or progress. Fear of recurrence can impact patients' quality of life and wellbeing. Cancer survivors' families support them practically and emotionally, making them a vital supplement for official healthcare. Given the well-established important role of the family in dealing with cancer, we compiled the studies that examined the relationship between family-related factors and fear of cancer recurrence (FCR) among cancer survivors (CSs). One of the foremost studies in this field is the FCR model presented by Mellon and colleagues, which included concurrent family stressors and family-caregiver FCR as factors linked to survivor FCR. Our goal was to prepare the ground for a family-based model of FCR that is more comprehensive than the one proposed by Mellon et al. sixteen years ago. The studies included those with samples of adult cancer survivors from different regions of the world. Most of the studies we reviewed are cross-sectional studies. We categorized family-related factors associated with survivor FCR into partner-related factors, including subgroups of disclosure to partner, cognitions of partner, and partner's sources of support; parenthood-related factors, including having children and parenting stress; family-related factors, including living situation, family history of cancer, family's perception of the illness, and family characteristics; and social interactions including social support, disclosure, social constraints, and attitudes of others. This review sheds light on how significant others of cancer survivors can affect and be affected by cancer-related concerns of survivors and emphasizes the necessity of further investigation of family-related factors associated with FCR.

Fear of progression among postoperative patients with newly diagnosed lung cancer: a cross-sectional survey in China

BACKGROUND

More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients.

OBJECTIVE

To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection.

METHODS

A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP.

RESULTS

The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18-39 years) than middle-aged patients (40-59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40-59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18-39 years and 40-59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients' age, the time from surgery and SSRS score were found to be independently associated with higher FoP.

CONCLUSIONS

High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.

Correlates of Cancer-Related Fatigue among Colorectal Cancer Patients Undergoing Postoperative Adjuvant Therapy Based on the Theory of Unpleasant Symptoms

BACKGROUND

Cancer-related fatigue (CRF) is a common and burdensome symptom in cancer patients that is influenced by multiple factors. Identifying factors associated with CRF may help in developing tailored interventions for fatigue management. This study aimed to examine the correlates of CRF among colorectal cancer patients undergoing postoperative adjuvant therapy based on the theory of unpleasant symptoms.

METHODS

A cross-sectional study was implemented, and finally, a sample of 363 participants from one tertiary general hospital and one tertiary cancer hospital was purposively recruited. Data were collected using the general information questionnaire, cancer fatigue scale, the distress disclosure index, Herth hope index, and perceived social support scale. Univariate analysis and multiple linear regression analysis were performed to determine the correlates of CRF.

RESULTS

The mean score of CRF among colorectal cancer patients was 21.61 (SD = 6.16, 95% CI 20.98-22.25), and the fatigue degree rating was "moderate". The multiple linear regression model revealed that 49.1% of the variance in CRF was explained by hope, sleep disorder, internal family support, self-disclosure, pain, and time since operation.

CONCLUSIONS

Our study identified several significant, modifiable factors (self-disclosure, hope, internal family support, pain, and sleep disorder) associated with CRF. Understanding these correlates and developing targeted psychosocial interventions may be associated with the improvement of CRF in patients with colorectal cancer.