Breast cancer survivors-supportive care needs: systematic review

The relationship between psychosocial support service utilization, coping and post-traumatic growth among breast cancer survivors

BACKGROUND

While data demonstrate psychosocial support services as effective mechanisms for improving the psychological well-being of breast cancer survivors (BCS), reviews indicate more research is needed to confirm this finding. The current study examined the relationship between psychosocial support service utilization (PSSU) on adaptive coping (AC) and post-traumatic growth (PTG) among BCS.

METHODS

Seventy-two Non-Hispanic Black and Non-Hispanic White BCS completed a survey assessing socio-demographic/clinical characteristics, PSSU (none, one type, multiple types), AC, and PTG. Analysis of covariance was used to examine the relationship between PSSU and AC/PTG indices.

RESULTS

Seventy-two percent of all respondents indicated utilizing one or more psychosocial support services. Among all respondents, as PSSU increased, all measures of AC and PTG significantly increased (p < 0.05). Analyses within race/ethnic groups showed similar patterns.

CONCLUSIONS

This study provides evidence of the positive relationship between PSSU and psychological well-being among a diverse group of BCS.

Quantifying the Influence of Psychosocial Characteristics, Supportive Care Needs and Quality of Life on Breast Cancer Survival

OBJECTIVE

To identify the contribution of psychosocial characteristics, supportive care needs, or quality of life on breast cancer survival outcomes.

METHODS

This study used data from a population-based longitudinal study involving women diagnosed with invasive breast cancer (n = 3326, response rate = 71%) in Queensland, Australia, 2010-2013, and followed up to 2020. Flexible parametric survival models were used to identify which factors were associated with survival outcomes. Model fit was assessed using D andR D 2 ${R}_{D}^{2}$ statistics.

RESULTS

Unmet physical and daily living needs, social support, age, stage at diagnosis, tumour grade, clinical subtype and mode of detection explained 39% of survival variability (R D 2 ${R}_{D}^{2}$ 0.39; 95% CI 0.33-0.44), with a Harrell's C statistic of 0.84 (95% CI 0.81-0.86). Unmet physical and daily living needs and social support, which fall under the categories of supportive care needs and psychosocial characteristics respectively, were identified as key factors that predict breast cancer survival, explaining 3% of survival variability. When compared to women who had less unmet physical needs and adequate social support (5-year survival: 96.6%, 95% CI 92%-99%), those who had more unmet physical needs and limited social support had poorer breast cancer-specific survival (5-year survival: 86.8%, 95% CI 72%-95%).

CONCLUSION

The study found that unmet physical and daily living needs and social support play a marginal but significant role in influencing breast cancer outcomes. The findings enhance the current literature regarding the impact of psychosocial characteristics and supportive care needs on breast cancer survival and suggest that integrating psychosocial support and interventions alongside medical treatment may further improve the survival outcomes for women diagnosed with breast cancer.

Effects of Health Education on Self-efficacy, Negative Emotions, and Life Quality in Breast Cancer Patients: A Systematic Review and Meta-analysis

BACKGROUND

Breast cancer patients encounter challenges managing acute and chronic symptoms during and after treatment, leading to emotional fluctuations and diminished quality of life. Health education aims to improve knowledge and life skills; however, its specific impact on breast cancer patients' self-efficacy is unclear.

OBJECTIVE

To assess the effects of health education on self-efficacy, depressive symptoms, anxiety, distress, and life quality in breast cancer patients.

METHODS

Randomized controlled studies were systematically screened in 7 databases from inception of the database to May 1, 2024. Literature quality was assessed using the Cochrane Risk of Bias Assessment tool. Results were pooled using random-effects meta-analyses and reported as standardized mean difference. Heterogeneity was reported using I2 statistic.

RESULTS

Sixteen articles were included. Participants in the intervention group exhibited enhanced self-efficacy in posttest (standardized mean difference [SMD], 0.12; 95% confidence interval [CI], 0.01-0.23; P = .04, I2 = 8%) and during the follow-up period (SMD, 0.30; 95% CI, 0.09-0.52; P = .006, I2 = 63%), decreased depressive symptoms (SMD, -0.30; 95% CI, -0.52 to -0.08; P = .0007, I2 = 17%), and increased life quality (SMD, 0.25; 95% CI, 0.01-0.49; P = .04, I2 = 48%) during the follow-up period.

CONCLUSIONS

Health education can enhance self-efficacy, reduce depressive symptoms, and improve the life quality of breast cancer patients. However, more rigorous research is needed to evaluate their effectiveness due to suboptimal blinding.

IMPLICATIONS FOR PRACTICE

The study underscores the critical role of health education in breast cancer management, emphasizing the necessity of integrating comprehensive health education programs into standard care protocols.

Digital and nurse-led support intervention in primary care during the first year after curative intent treatment for breast or prostate cancer: study protocol of two cluster randomised controlled pilot trials

INTRODUCTION

The period directly after primary treatment for breast or prostate cancer is a time when patients feel unprepared about how to manage life and address unexpected health challenges. Supportive care should focus on identifying symptoms and concerns and involving survivors in their self-care. Interventions using a blended model encompassing remote and in-person components may inform how supportive care can be organised. This protocol describes two pilot randomised controlled trials with the aim to investigate the acceptability, feasibility and potential effects of a 6 month digital and nurse-led support intervention in primary care for patients with breast or prostate cancer during the first year after primary treatment.

METHODS AND ANALYSIS

Two cluster randomised pilot trials including patients with breast or prostate cancer during the first year after ending primary treatment will run from 2023 in primary care centres in Region Stockholm. The trials will have an estimated sample size of 20 patients in each arm. The intervention groups receive a digital and nurse-led support intervention in combination with standard care, and the control groups receive standard care alone. To assess acceptability and feasibility, the participants in the intervention groups and the study nurses will be interviewed. Furthermore, digitally logged data and field notes by study-specific nurses will be analysed. Data collection for the potential effects of the intervention is conducted through self-reported standardised and validated questionnaires at baseline, and at 3, 6, 12, 18 and 24 months. Data entry and analyses will be blinded to the researchers. Qualitative data will be analysed with content analysis, quantitative data will be evaluated by comparing changes within and between groups.

ETHICS AND DISSEMINATION

This project was reviewed and approved by the Swedish Ethical Review Authority. Study results will be published in peer-reviewed journals and presented at scientific and professional meetings.

TRIAL REGISTRATION NUMBERS

ClinicalTrials.gov, NCT06471452 and NCT05100121.

Social support, fear of cancer recurrence and sleep quality in breast cancer: A moderated network analysis

PURPOSE

Fear of cancer recurrence (FCR) contributes to sleep problems and social support is a buffering factor in the literature. However, the moderating effect of social support between FCR and sleep quality is unclear.

METHODS

The moderating role of social support was examined in a cohort of 460 breast cancer patients from the 2024 Be Resilient to Breast Cancer (BRBC) program from a microscopic perspective using moderated network analysis, and then assessed macroscopically by Johnson-Neyman and response surface analysis. The Fear of Progression Questionnaire-Short Form, Perceived Social Support Scale and Pittsburgh Sleep Quality Index scale were employed in this study.

RESULTS

Social support significantly moderated the relationship between general anxiety and sleep efficiency. General anxiety was positively correlated with sleep efficiency at high levels of social support (t = 3.774, P < 0.001). Patients with high social support and low FCR experienced better sleep (F = 6.166, P < 0.01).

CONCLUSION

Our study deepens the understanding of the association between FCR, social support, and sleep quality, and emphasizes social support as a positive strategy for cancer patients to improve their physical and mental health.

Supportive care and information needs in relation to quality of life among patients with breast cancer and gynaecological cancer during the time of treatment

PURPOSE

Although therapy and psychosocial care for patients with breast cancer and gynaecological cancer has improved in the last years, there are still many issues that require further investigation. Unmet supportive care needs can lead to a lower adherence to treatment and a lower quality of life. Patients' needs seem to be highest during the time of treatment. Thus, this study investigated needs and quality of life.

METHODS

In this German prospective study, we enrolled 292 patients with breast cancer and gynaecological cancer during the time of treatment. Data on needs were assessed using instruments that had proven feasible in earlier studies. Data on quality of life (QoL) were assessed using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30). We investigated correlations between needs and sociodemographic data as well as quality of life.

RESULTS

Among all cancer entities we observed that 150 patients (51.5%) showed unmet information needs, 221 patients (75.7%) showed at least one high supportive care need, and 91 patients (31.2%) had psychological care needs. Data showed statistically significant correlations between these needs and sociodemographic data as well as quality of life. These correlations generally showed small to medium effect sizes. Older women showed less supportive care needs (r = - 0.24; p < 0.001), (r = - 0.15; p = 0.010). Furthermore, recruitment after surgery was associated with statistically significant higher information needs (r = 0.14; p = 0.015), whereas recruitment during chemotherapy was associated with statistically significant less information needs (r = - 0.15; p = 0.013). Positive correlations were shown for the level of received information and physical functioning (r = 0.12; p = 0.047), social functioning (r = 0.16; p = 0.009) and global quality of life (r = 0.19, p = 0.002) as well as satisfaction with information and physical (r = 0.16; p = 0.006), social (r = 0.24; p < 0.001), cognitive functioning (r = 0.14; p = 0.017) as well as global quality of life (r = 0.25; p < 0.001). Negative correlations were reported for information needs and emotional functioning (r = - 0.12; p = 0.035) and global quality of life (r = - 0.15; p = 0.011). Supportive care needs also correlated negatively with physical (r = - 0.23; p < 0.001), role (r = - 0.23; p < 0.001), emotional (r = - 0.35; p < 0.001), cognitive (r = - 0.24; p < 0.001), social functioning (r = - 0.30; p < 0.001), and global quality of life (r = - 0.35; p < 0.001). Also, patients with at least one high supportive care need correlated negatively with role (r = - 0.15; p = 0.014), emotional (r = - 0.23; p < 0.001), social functioning (r = - 0.30; p = 0.001), and global quality of life (r = - 0.35; p < 0.001). There was no statistical significance concerning cancer side. Thus, both groups are reported together. Furthermore, there was no statistical significance concerning disease status.

CONCLUSION

Overall, this study highlights the importance of tailored information and supportive care interventions. Addressing these needs, particularly in terms of information provision and psychosocial support, could lead to improved quality of life and better overall patient outcomes.

Risk Factors for Treatment Toxicity and High Side Effect Burden Among Breast Cancer Survivors: A Retrospective Chart Review

BACKGROUND/OBJECTIVES

This study describes the sequelae, side effects, and toxicities experienced by Canadian breast cancer survivors at a breast cancer survivorship clinic at a tertiary academic cancer centre and identifies potential risk factors which may be associated with increased side effect burden.

METHODS

A retrospective chart review was performed of adult patients treated at the Sunnybrook Breast Cancer Survivorship Clinic from 6 July 2022, to 30 September 2023 (n = 435).

RESULTS

Most patients (72.6%) reported at least one side effect impacting their quality of life, and a smaller majority (55.4%) reported two or more side effects. The most common symptoms experienced were anxiety (29.4%), chronic pain (23.9%), hot flashes (21.4%), and fear of recurrence (19.8%). Older age was strongly correlated with a lower likelihood of experiencing greater side effect burden (p < 0.01). Patients who underwent chemotherapy were significantly more likely to experience higher side effect burden than patients who did not. Current smokers were more likely than nonsmokers or past smokers to have a higher burden, for both physical (p < 0.01) and psychological side effects (p < 0.01). The multivariate analysis demonstrated that younger age was strongly associated with greater side effect burden, higher likelihood of psychological and physical symptoms, and greater likelihood of requiring close follow-up.

CONCLUSIONS

The results highlight the need for survivorship resources tailored to survivors under the age of 55 and the importance of referring smokers to smoking cessation programs. Additional research is required to explore the significant reluctance among patients regarding discharge. Future studies should examine the acute needs of younger breast cancer survivors and investigate the impact of smoking and treatment modalities on the side effect burden.

The healthy eating index may not be an appropriate indicator for assessing dietary quality in breast cancer survivors: results from NHANES 2005-2018

Background

Evidence on the relationship between the Healthy Eating Index (HEI) and mortality in breast cancer (BC) survivors remains inconclusive. Moreover, rare studies have explored the effect of individual HEI components on survival in this population. This study explored the association between the HEI-2020, including total and 13 component scores, and mortality in BC survivors.

Methods

This cross-sectional study included data of 481 female BC survivors (representing a 3.3 million population) obtained from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. The HEI-2020 total and component scores (higher scores indicating superior dietary quality) were calculated based on the 24 h dietary recall interview. Data on mortality until December 31, 2019, were obtained from the NHANES Public-Use Linked Mortality File. The weighted Cox proportional hazards models were used to assess the association between HEI-2020 and mortality outcomes.

Results

After fully adjusting for confounders, a qualified total HEI-2020 score (≥60) was significantly associated with reduced non-cancer mortality (HR 0.59, 95%CI: 0.35-0.99), but not with all-cause or cancer-specific mortality. Among the 13 HEI components, a lower intake of added sugars (with a qualified component score) was linked to a decreased risk of both all-cause and non-cancer mortality (HR 0.44 and 0.25, 95%CI: 0.25-0.77 and 0.13-0.48, respectively, all p < 0.05). Conversely, higher consumption of seafood and plant proteins (with a qualified component score) correlated with an increased risk of cancer-specific mortality (HR 3.64, 95%CI: 1.57-8.45), and a higher intake of dairy was associated with an elevated risk of both all-cause and non-cancer mortality (HR 2.12 and 2.81, 95%CI: 1.36-3.29 and 1.56-5.07, respectively).

Conclusion

Higher total and component scores of the HEI-2020 do not uniformly confer a lower mortality risk for BC survivors. The HEI-2020 may not be an appropriate indicator for post-diagnosis dietary assessment or recommendations for BC survivors.

Supportive and palliative care needs in advanced non-malignant liver disease: systematic review

Advanced cirrhosis confers a significant symptom burden and has a 50% 2-year mortality rate in those with decompensated disease. There is increasing demand for supportive and palliative care (SAPC) for these patients, yet no consensus on the best model of delivery. It is necessary to identify the needs of such patients and their carers, and evaluate whether they are being met.A literature search was conducted using key words pertaining to adult patients with liver cirrhosis and their SAPC needs. Study quality was assessed and findings grouped by theme. 51 full texts were selected for inclusion, 8 qualitative studies, 33 quantitative studies, 7 systematic reviews, 2 mixed methods studies and 1 Delphi methods. Key findings were grouped into three main themes: SAPC needs, access to SAPC and models of care.Patients with cirrhosis have significant psychological and physical symptom burden with many unmet needs. These data failed to identify the best service model of care. The impact of specialist palliative care (SPC) referral was limited by small numbers and late referrals. With the majority of studies conducted in the USA, it is unclear how well these findings translate to other healthcare systems. Comparison between hepatology led services and SPC was limited by inconsistent outcome measures and prevented pooling of data sets. These data also had limited evaluation of patient-reported outcome measures. We propose the development of a core outcome set to ensure consistent and meaningful evaluation of the SAPC needs of patients with advanced non-malignant liver cirrhosis.

Financial burden of lymphedema among breast cancer survivors in Iran: A qualitative study

BACKGROUND

Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer that requires long-term management. This condition imposes significant disturbance on breast cancer survivors (BCSs) physically, emotionally, and, financially. The purpose of this study was to approach the financial burden of BCRL in Iran.

METHODS

This qualitative study was performed based on the standards for reporting qualitative research (SRQR) guidelines. Semi-structured and in-depth interviews were conducted using a voice recorder. Data analysis was performed based on the content analysis method of Graneheim and Lundman. Nine women with BCRL participated in the study.

RESULTS

Three major themes were generated based on the captured data: (1) direct costs related to BCRL management, (2) indirect costs imposed by BCRL at work or home, and, (3) benefits of costs which was a great concern of BCSs that how much these costs eventually make their condition better. High costs of garments, lack of insurance coverage, and, difficulties in accessing lymphedema care were among the frequently mentioned problems by BCSs with BCRL.

CONCLUSION

The financial burden of BCRL is significant on BCSs in Iran. The establishment of insurance coverage policies, easier access to health services, and, implanting patient-centered measures in evidence-based lymphedema guidelines, could be proper interventions to lower the financial burden of BCRL.

Supportive care needs after surgery in patients with breast cancer

PURPOSE

This study aimed to determine supportive care needs and related factors after surgery in patients with breast cancer.

METHODS

This cross-sectional study was conducted with 98 breast cancer patients in a Training and Research Hospital in Istanbul between September 2022 and November 2023. The Personal Information Form and the Supportive Care Needs Survey Short Form Turkish version were used to collect data. One-way variance analysis, post hoc (Tukey, LSD), and t-test were used to analyze the data.

RESULTS

The total scale mean score for women who underwent surgery for breast cancer in the study was 83.95 22.97. Statistically significantly higher total scale scores were observed in younger women and those who received chemotherapy and radiotherapy than in others. The mean physical and daily living subscale scores of those who received chemotherapy and radiotherapy were higher than those who did not (p < .05). The psychology subscale mean scores of those who were young and unemployed were higher than the others (p < .05). The mean sexuality scores of those who were young, those with high education levels, and those who received chemotherapy were higher than the other groups (p < .05). Age factor affects SCN scores in women with breast cancer.

CONCLUSION

Supportive care needs are higher among women with breast cancer who are younger and receive chemotherapy and radiotherapy. The physical needs of those who receive chemotherapy and radiotherapy, the psychological needs of those who are younger and unemployed, and the need for support regarding sexuality were greater among those who are younger and with higher education. Nurses should be aware of the specific needs of these disadvantaged groups and provide individualized holistic care.

Health Information Needs of Breast Cancer Survivors: An Umbrella Review

Purpose

The aim of this umbrella review was to identify the main information needs of breast cancer survivors. Since several reviews have already been done on this topic, conducting an umbrella review not only combines their results but also gives a comprehensive picture and informative summary of breast cancer survivors' needs.

Method

The search was performed in PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane, and Google Scholar from inception to the end of March 2024. This review was conducted according to the JBI methodology for umbrella reviews, and the report was based on Rutten's category for information needs of patients with cancer. After removing duplicate and irrelevant articles, 14 systematic reviews were included in the analysis. The JBI checklist was used for evaluating the quality of eligible articles.

Results

The information needs were classified into 11 main categories and 86 subcategories. As a result of this umbrella review, one category was added to Rutten's 10 categories. Also, treatment information needs were introduced as the main identified category. Information on supportive care needs ranked second, and body image/sexuality information needs ranked third with a slight difference.

Conclusion

The information needs outlined in the present study can serve as a general model to help clinical decision makers and policymakers in order to better understand the needs of the group and meet the information needs of the population. Implications for Cancer Survivors. These recommendations can promote and develop targeted interventions to reduce the psychosocial consequences of breast cancer survivors and increase their quality of life.

Experiences of Patients with Breast Cancer Participating in a Prehabilitation Program: A Qualitative Study

Background: Breast cancer (BC) is the most prevalent cancer diagnosis among women worldwide. Several randomized controlled trials and systematic reviews have shown the benefits of exercise before, during, and after cancer treatment to manage side effects related to cancer and its therapies. However, these are poorly implemented across the disease-span, specifically, during the preoperative setting. Methods: Patients diagnosed with BC and participating in a randomized controlled trial on the effects of a prehabilitation program based on Nordic walking, muscle strengthening, and therapeutic education were invited to participate in this qualitative substudy. Two groups of eight patients each were recorded, transcript and analyzed using a specialized software (Atlas-Ti®, version 24). Results: During the axial codification phase, 22 unique codes and 6 main themes were identified related to their experience with the program, namely, (1) information received prior to participating; (2) motivation to participate; (3) barriers; (4) facilitators; (5) perceived degree of support from healthcare workers as well as peers; and (6) satisfaction with the characteristics of the prehabilitation program. Conclusions: Patients interviewed showed great interest in prehabilitation as a way to prepare both physically and mentally for surgery. In order to implement these interventions, healthcare systems need to acknowledge barriers and facilitators as well as the need for these programs to be supervised and monitored to avoid adverse events.

Antiproliferative and Apoptotic Effects of Tempol, Methotrexate, and Their Combinations on the MCF7 Breast Cancer Cell Line

Breast cancer holds the top position among the cancers occurring in women. Despite the utilization of surgical removal, chemotherapy, and radiation therapy, there is currently no conclusive treatment available to prevent breast cancer. New treatment approaches are being studied since traditional chemotherapeutics also damage healthy cells. Tempol (TPL) is a potent antioxidant agent that has been shown to exhibit anticancer activity. The objective of this research was to examine the impacts on cell proliferation and apoptosis by using methotrexate (MTX) and TPL individually and in combination on MCF7 breast cancer cells. MCF7 cells were exposed to TPL, MTX, and MTX + TPL for 48 h. The effects of the administered drugs on cell viability were determined using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Enzyme-linked immunosorbent assay analysis was conducted to assess the levels of the antiapoptotic protein Bcl-2, the pro-apoptotic protein Bax, and the activity of caspase-3 in MCF7 cells. Increasing concentrations of TPL and MTX significantly decreased the proliferation in MCF7 cells in both solo and combined use. Solo and combined use of TPL and MTX significantly increased caspase-3 activity and Bax levels and significantly decreased Bcl-2 levels in the cells. This study revealed that the solo use of TPL and MTX inhibited proliferation and increased apoptotic activity in the cells. In addition, TPL increased the antiproliferative and apoptosis efficiency of MTX on cancer cells as a result of the combined use of these drugs.

Breast cancer survivorship needs: a qualitative study

BACKGROUND

Breast cancer rates and the number of breast cancer survivors have been increasing among women in Iran. Effective responses from healthcare depend on appropriately identifying survivors' needs. This study investigated the experience and needs of breast cancer survivors in different dimensions.

METHODS

In this qualitative content analysis, semi-structured in-depth interviews were conducted from April 2023 to July 2023. Data saturation was achieved after interviewing 16 breast cancer survivors (BCSs) and four oncologists using purposive sampling. Survivors were asked to narrate their experiences about their needs during the survivorship. Data were analyzed with an inductive approach in order to extract the themes.

RESULTS

Twenty interviews were conducted. The analysis focused on four central themes: (1) financial toxicity (healthcare costs, unplanned retirement, and insurance coverage of services); (2) family support (emotional support, Physical support); (3) informational needs (management of side effects, management of uncertainty, and balanced diet); and (4) psychological and physical issues (pain, fatigue, hot flashes, and fear of cancer recurrence).

CONCLUSIONS

This study provides valuable information for designing survivorship care plans. Identifying the survivorship needs of breast cancer survivors is the first and most important step, leading to optimal healthcare delivery and improving quality of life. It is recommended to check the financial capability of patients and take necessary measures for patients with financial problems. Additionally, support sources should be assessed and appropriate. Psychological interventions should be considered for patients without a support source. Consultation groups can be used to meet the information needs of patients. For patients with physical problems, self-care recommendations may also be useful in addition to doctors' orders.

Supportive Care Needs (SCN) of Cancer Patients Referred to the Medical Centers in Iran

OBJECTIVE

The aim of this study was to evaluate the Supportive Care Needs s of cancer patients in Iran.

METHODS

This descriptive-analytical, cross-sectional study was conducted on cancer patients referred to public and private medical centers in Gorgan (Northern Iran) in 2020. Cancer patients refered to private medical ccentes were recruited into the study using the convenience sampling method. The reliable and valid "Supportive Care Needs Survey-Short Form" (SCNS-SF) with 34 items in five domains of need (physical and daily living, psychological, sexuality, patient care and support, health system, and information) was used to collect data.

RESULTS

Out of 247 patients, 54.7% were females with a mean age of 46.15± 9.36. The most common site of involvement was breast (25.1%), and the duration of involvement was 7.51±6.79 months. The total mean of SCNs was 68.80±18.5 so that the highest (73.68±15.03) and lowest (60.42±27.19) SCNs were related to physical and daily living as well as sexual domains, respectively. The highest frequency (62.3%) of SCNs was related to "fatigue/lack of energy".

CONCLUSION

This study showed that cancer patients experienced many unmet needs in various dimensions. Therefore, it is necessary to address these needs simultaneously treating the disease and developing and implementing a care plan based on patients' priorities.

Association between self-esteem and fear of cancer recurrence in cancer survivors: A cross-sectional study

PURPOSE

There may be a correlation between self-esteem as an important psychological resource for individuals and Fear of cancer recurrence (FCR), but the relationship between the two is unclear. The aim of our investigation was to evaluate the association of FCR and self-esteem in cancer survivors.

METHODS

Cross-sectional sampling was used to select cancer survivors. The study instruments used included: General information questionnaire, Rosenberg Self-Esteem Scale, Perceived Social Support Scale, Fear of Cancer Recurrence Inventory- Shorter Form. We used logistic regression, where models were adjusted considering confounding variables to determine odds ratios (ORs) with 95% confidence intervals (CIs) for the association of FCR with self-esteem.

RESULTS

Between February 2022 to July 2022, we screened 380 participants for eligibility, of whom 348 were included in the study. The percentage of cancer survivors who experienced clinical level of FCR was 73.9% and the self-esteem score was 27.73 ± 3.67 at a moderate level. The Pearson' s correlation coefficient indicated a significant inverse relationship between FCR and self-esteem (p < 0.001; r = -0.375). In a multivariable logistic regression model, FCR still has a negative correlation with self-esteem (OR, 0.812; 95%CI, 0.734-0.898). Subgroup analysis indicated that the correlation between FCR and self-esteem in cancer survivors was nearly the same in various strata, demonstrating its soundness and stability.

CONCLUSIONS

This study confirms that elevated self-esteem in individuals surviving cancer may be a protective factor for FCR. Improving the level of self-esteem in cancer survivors can be one of the important directions of clinical interventions for FCR.