Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia.
Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Graduate School of Health, University of Technology, Sydney, NSW, Australia.
Eur J Oncol Nurs. 2020 Dec;49:101845. doi: 10.1016/j.ejon.2020.101845. Epub 2020 Oct 10.
The aim of this study was to quantify the prevalence of Fear of Cancer Recurrence (FCR) in patients with a prior haematology malignancy surviving more than one year post allogeneic haematopoietic stem cell transplantation (HSCT), and to identify the demographic, medical and psychological factors associated with FCR occurrence.
Participants were adult allogeneic HSCT recipients who had undergone the procedure for acute leukaemia or other haematological malignancy between the years 2000-2012 in Sydney, Australia. They completed a purpose designed survey and six other validated instruments which assessed FCR, psychological functioning, quality of life, demographic, social and clinical variables.
Of the 364 respondents, approximately 11% of the sample lived with severe FCR while only 5% of subjects reported having no FCR. Variables significantly associated with higher FCR included unemployment, a shorter time (years) post-transplant, not attending to health screening (PAP smear), a secondary diagnosis of skin cancer, younger age, referral to a psychiatrist and taking psychotropic medication. Higher psychological distress (depression, anxiety, stress) and lower quality of life made a significant contribution to the prediction of FCR.
Post HSCT follow-up care should include an assessment and discussion regarding FCR to balance both realistic and unrealistic cancer recurrence risks. Managing FCR is one of the most ubiquitous unmet needs of survivors of haematological disease and it is important that HSCT nurses are both aware of the fear, and are equipped with knowledge on how to help patients navigate it with realistic expectations.
本研究旨在量化在经历过异基因造血干细胞移植（HSCT）一年以上的血液系统恶性肿瘤幸存者中，对癌症复发的恐惧（FCR）的发生率，并确定与 FCR 发生相关的人口统计学、医学和心理因素。
参与者为在澳大利亚悉尼接受 2000-2012 年急性白血病或其他血液系统恶性肿瘤治疗的异基因 HSCT 受者。他们完成了一项专门设计的调查和另外六项评估 FCR、心理功能、生活质量、人口统计学、社会和临床变量的验证工具。
在 364 名受访者中，约有 11%的样本存在严重的 FCR，而只有 5%的患者报告没有 FCR。与更高 FCR 显著相关的变量包括失业、移植后时间（年）较短、未参加健康筛查（巴氏涂片）、皮肤癌的次要诊断、年龄较小、转介至精神科医生和服用精神药物。较高的心理困扰（抑郁、焦虑、压力）和较低的生活质量对 FCR 的预测有显著贡献。
HSCT 后随访护理应包括对 FCR 的评估和讨论，以平衡现实和不切实际的癌症复发风险。管理 FCR 是血液系统疾病幸存者最普遍的未满足需求之一，重要的是 HSCT 护士既要意识到恐惧，又要具备如何帮助患者以现实的期望应对恐惧的知识。
