Department of Psychology, The University of Iowa.
Department of Otolaryngology-Head and Neck Surgery, The University of Iowa Hospitals and Clinics.
Health Psychol. 2014 Apr;33(4):373-81. doi: 10.1037/a0032680. Epub 2013 Jun 17.
To examine the impact of fear of recurrence (FOR) on health-related quality of life (HRQOL) and tobacco use among head and neck cancer (HNC) survivors.
A cross-sectional subset of patients (N = 138) from a large, prospective study of oncologic outcomes in HNC was assessed for FOR, in addition to the parent study's ongoing assessments of HRQOL and tobacco use. FOR was measured using the Fear of Cancer Recurrence Inventory and HNC-specific HRQOL was assessed with the Head and Neck Cancer Inventory (HNCI). Tobacco use was patient-reported as "Current," "Previous," or "Never."
After controlling for relevant clinical and demographic variables, hierarchical regression analyses revealed that higher FOR significantly predicted lower HRQOL across all HNCI domains (eating (p < .05), aesthetics (p < .01), speech (p < .01), and social disruption (p = .001)) and increased tobacco use (p < .01). A total of 60.1% of the sample expressed clinically significant levels of FOR. These patients reported lower HRQOL (eating: p < .05, aesthetics: p < .05, social disruption: p < .05) and were more likely to be using tobacco compared with patients with subclinical FOR (26.6% and 4.9%, respectively; p < .01).
Results suggest that FOR is prevalent among HNC survivors and is related to decreased HRQOL and increased tobacco use.
探讨复发恐惧（FOR）对头颈部癌症（HNC）幸存者健康相关生活质量（HRQOL）和烟草使用的影响。
从一项大型前瞻性 HNC 肿瘤学结局研究的患者中，选取了一个横断面亚组（N=138），评估了 FOR，以及该研究正在进行的 HRQOL 和烟草使用评估。使用癌症复发恐惧量表（Fear of Cancer Recurrence Inventory）测量 FOR，使用头颈部癌症量表（Head and Neck Cancer Inventory，HNCI）评估 HNC 特定的 HRQOL。烟草使用情况由患者报告为“当前”、“以前”或“从不”。
在控制了相关临床和人口统计学变量后，分层回归分析显示，较高的 FOR 显著预测了所有 HNCI 领域的 HRQOL 降低（进食（p<0.05）、美观（p<0.01）、言语（p<0.01）和社会干扰（p=0.001））和增加烟草使用（p<0.01）。样本中共有 60.1%的患者表达了临床显著水平的 FOR。这些患者报告的 HRQOL 较低（进食：p<0.05，美观：p<0.05，社会干扰：p<0.05），并且与具有亚临床 FOR 的患者相比，更有可能使用烟草（分别为 26.6%和 4.9%；p<0.01）。
结果表明，FOR 在 HNC 幸存者中普遍存在，与 HRQOL 降低和烟草使用增加有关。
