Effects of Social Support, Family Resilience, and Individual Resilience on Fear of Cancer Recurrence Among Persons With Breast Cancer: A Cross-Sectional Study

Latent profile analysis of fear of progression in Chinese hematologic malignancy survivors

Fear of disease progression (FoP) is a multidimensional concept that refers to the fear or worry about disease progress. Little is known about the distinct FoP profiles and their determinants in culturally specific contexts, especially among hematologic malignancies (HM) patients in China. This study aimed to identify heterogeneous profiles of FoP and their associated predictors among Chinese patients with HM. A convenience sample of patients suffering from HM were enrolled from March 2023 to February 2024. To gather multidimensional data from the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Hospital Anxiety and Depression Scale (HADS), the Family Hardiness Index (FHI), and the EuroQol-Visual Analogue Scale (EQ-VAS), we performed a questionnaire-based cross-sectional study on 455 survivors with HM. The statistical method included latent profile analysis (LPA) and multivariate logistic regression. Three latent profiles of FoP were found: the low-risk fear group (20.88%), the moderate-risk fear group (54.73%), and the high-risk fear group (24.49%). Patients with higher levels of illness perception, anxiety, and depression were more likely to report higher levels of FoP. The study revealed that female gender (OR 2.295-2.577), age > 65 years (OR 4.140-9.363), lower education (OR 0.270-0.365), and lymphoma diagnosis (OR 2.95) significantly predicted higher FoP risk (all P < 0.05), while higher income (OR 0.390-0.477, P < 0.05) and greater family resilience showed protective effects. The findings underscore the need for risk-stratified interventions targeting psychosocial vulnerabilities, particularly in elderly and female adults with HM. This study provides empirical evidence supporting the application of precision psycho-oncology approaches in HM survivorship management. It also contributes to the broader comprehension of FoP and highlights the importance of family-centered interventions .

Transcultural Adaptation and Evaluation of the Psychometric Properties of the Spanish Version of the FCR7 Questionnaire for Assessing Fear of Recurrence in Cancer Patients: FCR6/7-SP

BACKGROUND/OBJECTIVES

Fear of recurrence is one of the main issues affecting cancer patients after the completion of treatment. Despite the development of various assessment tools at the international level, there is a lack of validated questionnaires in Spanish. For this reason, the aim of this study is to conduct a transcultural adaptation and evaluate the psychometric properties of the Spanish version of the Fear of Cancer Recurrence (FCR7) questionnaire.

METHODS

We carried out translation and transcultural adaptation of the FCR7 scale, content validity through expert review, and face validity with a pilot test in the first phase. In the second phase, construct validity was evaluated through confirmatory factor analysis and Rasch analysis, along with reliability (internal consistency), convergent-divergent validation, and known-groups validation in a sample of 315 individuals with a history of cancer. Descriptive and inferential analysis was performed using JAMOVI© v.2.3.24., confirmatory factor analysis with FACTOR© v.12.02.01x64 bits, and Rasch analysis with JMetrik© v.2.0.

RESULTS

Aiken's coefficient exceeded 0.75 for all items, indicating acceptable face validity for the instrument. Two unidimensional models were obtained for the instrument, FCR7-SP and FCR6-SP, both showing acceptable fit values and adequate reliability (omega coefficient = 0.933 [95% CI: 0.922-0.944] and 0.942 [95% CI: 0.931-0.951], respectively).

CONCLUSIONS

The Spanish version of the FCR7 is valid and reliable for assessing fear of cancer recurrence in the Spanish population, with two models available for its application (FCR7-SP and FCR6-SP). The availability of this tool will enable the evaluation of this phenomenon in clinical practice and a more effective approach to addressing its consequences.

Coping and Positive Body Image in Young Women with Breast Cancer: The Buffering Role of Social Support

Background/Objectives: Considering the unique body image challenges faced by young women with breast cancer, this study aims to deepen our understanding of how coping strategies and perceived social support contribute to fostering positive body image in this population. This is an important issue as body image is capable of influencing women's self-esteem and psychological adaptation to breast cancer. Methods: A sample of 157 young women with breast cancer (M age = 41.43; SD = 6.05; Min 26 years, Max 50 years), 43% of whom had undergone breast reconstruction, completed an online survey. The survey included measures of coping strategies, positive body image, and perceived social support. Results: No significant differences in coping strategies, perceived social support, or positive body image were observed based on reconstruction status. Moderation analyses revealed that both avoidant and problem-focused coping were significantly associated with positive body image at moderate and high levels of perceived social support, but not at low levels of perceived social support. Perceived social support moderated the relationship between coping strategies and positive body image in women with breast cancer. Conclusions: These findings highlight the importance of social support in enhancing the effectiveness of both avoidant and problem-focused coping strategies in promoting positive body image. Future interventions should prioritize strengthening social support networks to optimize psychological outcomes in this population.

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.

The efficacy of internet-based cognitive behavior therapy for psychological health and quality of life among breast cancer patients: a systematic review and meta-analysis

Objective

To systematically investigate the effect of Internet-based cognitive-behavioral therapy (ICBT) on depression, anxiety, fatigue and quality of life (QOL) in patients with breast cancer (BC).

Methods

A systematic review with meta-analysis and qualitative evidence synthesis was performed. Ten databases, including PubMed, Web of Science, EMBASE, the Cochrane Library, CINAHL, JBI Chinese Biomedical database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfang, were searched from the start till August 2023. Published studies in English or Chinese were eligible for randomized and clinical controlled trials determining the efficacy of ICBT among BC survivors. The quality of the evidence was evaluated at the study level and the outcome level.

Results

In total, 11 clinical trials on 1,307 patients with BC (ICBT: 671, control: 636) were systematically reviewed. We found that ICBT is effective in alleviating psychological distress in BC survivors, and the quality of all studies was moderate. The meta-analysis indicated that ICBT affected primary outcomes of anxiety (standardized mean difference [SMD] = -0.71, 95% confidence interval [CI]: -1.19, -0.24, p < 0.0001), depression (SMD = -0.67, 95% CI: -1.07, -0.27, p < 0.0001), fatigue (SMD = -1.23, 95% CI: -2.37, -0.08, p < 0.0001) and QOL (SMD = 0.79, 95% CI: 0.21, 1.37, p < 0.00001).

Conclusion

This meta-analysis indicates that ICBT, as a type of psychosocial rehabilitation, can mitigate the incidence of depression, anxiety, and fatigue and improve the quality of life among patients with BC. Nevertheless, the effect is not distinct, and multi-centered randomized controlled trials with larger cohorts are warranted to verify the effectiveness of ICBT.

Spiritual needs of women with breast cancer: A structural equation model

PURPOSE

The purpose of this study was to develop a structural equation model (SEM) to explore the factors influencing the spiritual needs of breast cancer patients.

METHODS

A cross-sectional study was conducted in the breast surgery department of a tertiary hospital in China from September 2020 to December 2020; convenience sampling and questionnaires were used to facilitate sampling and data collection. A total of 220 female breast cancer patients were included in the study. The data were analysed using multiple linear regression and structural equation modelling.

RESULTS

Compared with patients with other diseases, patients with breast cancer have greater spiritual needs (76.16 ± 13.19). Multivariate analysis revealed that religious beliefs, education level, social support, and resilience are important factors affecting the mental health of women with cancer (p < 0.05). The structural equation model fit well (RMSEA = 0.056, χ2p = 0.002). Social support directly affected spiritual needs (β = 0.607, p < 0.001) and indirectly affected spiritual needs through resilience (β = 0.353, p < 0.001). Resilience directly affected spiritual needs (β = 0.386, p < 0.05). Education level indirectly affected spiritual needs through social support (β = 0.307, p < 0.001).

CONCLUSION

This study provides a theoretical basis for intervention measures to improve the spiritual needs of female breast cancer patients. Paying more attention to social support and resilience may help solve the problem of meeting the high spiritual needs of breast cancer patients. Further research is needed to develop interventions.

Dyadic effects of financial toxicity and social support on the fear of cancer recurrence in breast cancer patients and caregivers: an actor-partner interdependence mediation model

PURPOSE

In this study, the actor-partner interdependence mediation model (APIMeM) was applied to breast cancer patients and their caregivers to assess the factors that affect the fear of cancer recurrence. In particular, the purpose of this study was to evaluate the mediating effect of social support on financial toxicity and the fear of cancer recurrence, providing an effective basis for developing plans to reduce the level of fear of cancer recurrence.

METHODS

This study employed a cross-sectional design, and 405 dyads of breast cancer patients and their caregivers were enrolled. Financial toxicity, social support, and fear of cancer recurrence were assessed by computing comprehensive scores for financial toxicity based on patient-reported outcome measures, the Social Support Rating Scale, and the Fear of Cancer Recurrence Inventory Short Form, respectively. The data were analysed using SPSS 24.0 and AMOS 23.0.

RESULTS

The results showed that the fear of cancer recurrence of breast cancer patients and their caregivers was significantly related to dyadic financial toxicity and social support. In addition, the financial toxicity of breast cancer patients and their caregivers had significant actor effects and partner effects on the fear of cancer recurrence through dyadic social support.

CONCLUSIONS

The financial toxicity of breast cancer patients and their caregivers could produce actor and partner effects on the fear of cancer recurrence through the mediation of social support, which provided empirical support for improving reducing the level of fear of cancer recurrence among patients and caregivers at the dyadic level.

Independent predictors of family resilience in patients with ischemic stroke: A cross-sectional survey

Background

Globally, China bears the highest stroke burden, emphasizing the paramount importance of comprehending the influencing factors on family resilience among patients with ischemic stroke to promote their physical and mental well-being, as well as enhance the quality of their life. This understanding can concurrently assist healthcare professionals in formulating interventions aimed at fostering healthy family functioning.

Objective

To investigate the level of family resilience in patients with ischemic stroke and its predictive factors.

Methods

A total of 310 inpatients with ischemic stroke were recruited from three tertiary general hospitals in China between May and November 2021. The study employed a range of instruments for data collection, including the General data questionnaire, Family Resilience Rating Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale and Connor-Davidsion Re-silience Scale. Data analysis was conducted using SPSS 22.0 statistical software. Non-parametric tests, Spearman analysis, and multiple stepwise regression were employed to investigate the predictive variables of family resilience.

Results

A total of 303 patients successfully completed the investigation, yielding an efficacy rate of 97.74 %. The total scores for family resilience spanned from 87 to 245, with a median (P25, P75) of 187 (160, 200). The highest scores were observed in the dimension of dilemma interpretation, while the lowest scores were recorded in the dimension of social support. Family relationship (β = 0.459, P<0.001), positive coping (β = 0.182, P<0.001), out-of-family support(β = 0.156, P<0.001), in-family support (β = 0.147, P = 0.002), and optimism (β = 0.108, P = 0.013) were found to be predictive factors of family resilience.

Conclusion

Patients with high family resilience demonstrated superior family relationship, effective positive coping strategies, increased support within and outside the family, and a more optimistic attitude; these factors independently predict family resilience.

How Social Support Affects Resilience in Disadvantaged Students: The Chain-Mediating Roles of School Belonging and Emotional Experience

This study aims to utilize data from the Programme for International Student Assessment (PISA), 2018, conducted in four provinces and cities in China, to investigate the impact of social support on the resilience of disadvantaged students. It specifically focuses on the chain-mediated effects of school belonging and emotional experiences. To achieve this, the study selected 2997 disadvantaged students as participants and employed path analysis to examine the mediating effects. The results indicate that teacher support, parental support, school belonging, and positive emotional experiences significantly positively influence the resilience of disadvantaged students, while fear of failure significantly negatively affects resilience. Additionally, teacher and parental support indirectly impact the resilience of disadvantaged students through the chain-mediated effects of school belonging and positive emotional experiences. Similarly, teacher and parental support also influence the resilience of disadvantaged students through the chain-mediated effects of school belonging and fear of failure. To enhance the resilience development of disadvantaged students, it is recommended that teachers and parents provide active attention and support to these students. Simultaneously, there should be increased focus on the psychological well-being of disadvantaged students by strengthening their mental health education.