Department of Psychological Medicine, University of Auckland, New Zealand.
Br J Health Psychol. 2013 Feb;18(1):168-81. doi: 10.1111/bjhp.12003. Epub 2012 Nov 8.
Adjuvant endocrine therapy for early-stage breast cancer has greatly reduced the morbidity and mortality associated with breast cancer recurrence. Despite this, a significant proportion of women report fears of cancer recurrence. This study examined the associations between fear of cancer recurrence (FoR) and illness perceptions, medication beliefs, and treatment side effects in women taking adjuvant endocrine therapy following breast cancer.
A total of 153 post-menopausal women with early-stage breast cancer completed a postal survey. Analyses were conducted to examine the association between FoR and illness perceptions, medication beliefs, treatment side effects, demographic factors, and emotional distress and to identify which of these factors would be most strongly associated with FoR in a regression model.
All illness perceptions (apart from personal control) were associated with FoR, as were patient beliefs about endocrine therapy. Although treatment side effects, being unemployed, and higher levels of anxiety and depression were associated with FoR, only illness perceptions (identity, treatment control, timeline, and emotional representation) and medication necessity beliefs were significantly correlated with FoR in the final model.
It appears that, in addition to directly targeting FoR, it may be worthwhile to address the illness and medication beliefs supporting the fear. Additionally, helping women to differentiate everyday symptoms from those indicative of breast cancer may help to reduce fear of recurrence.
What is already known on this subject? A significant proportion of women report fear of cancer recurrence following breast cancer. The literature shows that illness perceptions, side effects of treatment, and beliefs about medicines are related to fear of recurrence among cancer patients. However, because these variables have often been looked at in isolation, it is not clear whether some perceptions or cues are more likely to relate to fear of recurrence than others. What does this study add? This study shows illness perceptions and medication beliefs are strongly related to fears of cancer recurrence. The results point to ways in which the self-regulatory model of illness may be used to reduce patients' fear of recurrence. The study results show that women with higher fear of recurrence may be balancing a tension between believing that they need to take the medication to protect their future health alongside concerns that the treatment may not be working.
早期乳腺癌的辅助内分泌治疗大大降低了与乳腺癌复发相关的发病率和死亡率。尽管如此，仍有相当一部分女性报告担心癌症复发。本研究调查了接受乳腺癌辅助内分泌治疗的女性中恐惧癌症复发（FoR）与疾病认知、药物信念和治疗副作用之间的关系。
共 153 名绝经后早期乳腺癌女性完成了邮寄调查。分析了 FoR 与疾病认知、药物信念、治疗副作用、人口统计学因素和情绪困扰之间的关系，并确定在回归模型中哪些因素与 FoR 关系最密切。
除个人控制外，所有疾病认知（身份、治疗控制、时间线和情绪表现）均与 FoR 相关，患者对内分泌治疗的信念也是如此。尽管治疗副作用、失业以及更高水平的焦虑和抑郁与 FoR 相关，但只有疾病认知（身份、治疗控制、时间线和情绪表现）和药物必要性信念与最终模型中的 FoR 显著相关。
除了直接针对 FoR，解决支持恐惧的疾病和药物信念可能也值得关注。此外，帮助女性区分日常症状和乳腺癌的症状可能有助于降低复发恐惧。
关于这个主题，目前已知的内容是什么？相当一部分女性在乳腺癌后报告害怕癌症复发。文献表明，癌症患者的疾病认知、治疗副作用和药物信念与恐惧复发有关。然而，由于这些变量经常被孤立地看待，目前尚不清楚哪些认知或线索更有可能与恐惧复发相关。本研究有何新增内容？本研究表明疾病认知和药物信念与恐惧癌症复发密切相关。研究结果指出了如何使用疾病的自我调节模型来降低患者对复发的恐惧。研究结果表明，恐惧复发程度较高的女性可能在权衡一种紧张关系，一方面她们认为需要服用药物来保护未来的健康，另一方面她们又担心治疗可能不起作用。
