Gormley Maurade, Ghazal Lauren, Fu Mei R, Van Cleave Janet H, Knobf Tish, Hammer Marilyn
Author Affiliations: New York University Rory Meyers College of Nursing (Dr Gormley, Ms Ghazal, and Dr Van Cleave), New York; Boston College Connell School of Nursing (Dr Fu), Massachusetts; Yale University School of Nursing (Dr Knobf), Orange, Connecticut; and Dana-Farber Cancer Institute (Dr Hammer), Boston, Massachusetts.
Cancer Nurs. 2022;45(1):E10-E26. doi: 10.1097/NCC.0000000000000858.
Fear of cancer recurrence (FCR) is the most prevalent need among breast cancer survivors. Age is the most consistent predictor of higher FCR, with prevalence rates as high as 70% among young adults. Although the association between age and higher FCR is well established, a more comprehensive understanding of the factors contributing to higher FCR among young adult breast cancer survivors is needed.
The purpose of this integrative review was to explore the factors associated with higher FCR among young adult breast cancer survivors (≤ 45 years old).
A literature search was conducted using PubMed, CINAHL, PsycINFO, and EMBASE databases with specific Medical Subject Headings terms delimited to FCR, diagnosis, sex, and age range. The initial search yielded 378 studies, 13 of which met the eligibility criteria.
Themes include motherhood status, health behaviors and decision making (eg, surveillance behaviors and surgical decision making), psychological morbidity, and social support. Cognitive behavioral factors include cognitive processing, metacognition, illness intrusiveness, and self-efficacy.
Fear of cancer recurrence among young adult breast cancer survivors is a unique construct requiring further exploration and tailored interventions to improve the health-related quality of life for this population.
Oncology nurses should screen all cancer survivors for FCR, with particular attention to the unique needs of young adults. Future research should address the role of age-appropriate support and increased levels of FCR during surveillance periods.
对癌症复发的恐惧（FCR）是乳腺癌幸存者中最普遍的需求。年龄是FCR较高的最一致预测因素，在年轻人中患病率高达70%。尽管年龄与较高的FCR之间的关联已得到充分证实，但仍需要更全面地了解导致年轻成年乳腺癌幸存者FCR较高的因素。
本整合性综述的目的是探讨年轻成年乳腺癌幸存者（≤45岁）中与较高FCR相关的因素。
使用PubMed、CINAHL、PsycINFO和EMBASE数据库进行文献检索，使用特定的医学主题词限定为FCR、诊断、性别和年龄范围。初步检索产生了378项研究，其中13项符合纳入标准。
主题包括母亲身份、健康行为和决策（如监测行为和手术决策）、心理疾病和社会支持。认知行为因素包括认知加工、元认知、疾病侵扰和自我效能感。
年轻成年乳腺癌幸存者对癌症复发的恐惧是一个独特的概念，需要进一步探索并采取针对性干预措施，以改善该人群与健康相关的生活质量。
肿瘤护士应筛查所有癌症幸存者的FCR，尤其要关注年轻人的独特需求。未来的研究应探讨适合年龄的支持措施的作用以及监测期间FCR水平升高的问题。
