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不如我们想象的那么稳定:对手术后0至5年的乳腺癌治愈性幸存者进行的12个月癌症复发恐惧评估的描述性研究

Not as Stable as We Think: A Descriptive Study of 12 Monthly Assessments of Fear of Cancer Recurrence Among Curatively-Treated Breast Cancer Survivors 0-5 Years After Surgery.

作者信息

Custers José Ae, Kwakkenbos Linda, van der Graaf Winette Ta, Prins Judith B, Gielissen Marieke Fm, Thewes Belinda

机构信息

Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands.

Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, Netherlands.

出版信息

Front Psychol. 2020 Nov 2;11:580979. doi: 10.3389/fpsyg.2020.580979. eCollection 2020.

Abstract

: Previous studies suggest one-third of breast cancer survivors (BCS) experience elevated fear of cancer recurrence (FCR) and that it remains stable. Most studies include long assessment intervals and aggregated group data. This study aimed to describe the individual trajectories of FCR when assessed monthly using both a statistical and descriptive approach. : Participants were curatively-treated BCS 0-5 years post-surgery. Questionnaire data were collected monthly for 12 months. Primary outcome was FCR [Cancer Worry Scale (CWS)]. For the descriptive approach, 218 participants were classified as low (CWS ≤ 13 at each assessment), high (CWS ≥ 14 at each assessment), or fluctuating FCR (CWS scores above and below cut-off). Latent class growth analysis (LCGA; = 377) was conducted to identify trajectories over time. : Around 58% of the women reported fluctuating CWS scores, 22% reported a consistently high and 21% consistently low course. Results of the LCGA confirmed the three-class approach including a stable high FCR group (13%), a low FCR group (40%), and a moderate FCR group (47%). Both the moderate and low scoring groups reported declining scores over time. Younger patients, higher educated patients, and those less satisfied with the medical treatment were more likely to belong to the moderate or high trajectory. : Assessed monthly, the majority of BCS report fluctuating levels of FCR. Stepped-care models should assess FCR on multiple occasions before offering tailored interventions.

摘要

以往研究表明,三分之一的乳腺癌幸存者(BCS)对癌症复发的恐惧(FCR)加剧,且这种恐惧保持稳定。大多数研究采用较长的评估间隔并汇总群体数据。本研究旨在通过统计和描述性方法,描述每月评估时FCR的个体轨迹。

参与者为术后0至5年接受根治性治疗的BCS。连续12个月每月收集问卷数据。主要结局指标为FCR[癌症担忧量表(CWS)]。对于描述性方法,218名参与者被分类为低FCR(每次评估时CWS≤13)、高FCR(每次评估时CWS≥14)或波动FCR(CWS评分高于或低于临界值)。进行潜在类别增长分析(LCGA;n = 377)以确定随时间的轨迹。

约58%的女性报告CWS评分波动,22%报告持续高评分,21%报告持续低评分。LCGA结果证实了三类方法,包括稳定的高FCR组(13%)、低FCR组(40%)和中度FCR组(47%)。中度和低评分组均报告随时间评分下降。年轻患者、受教育程度较高的患者以及对医疗治疗不太满意的患者更有可能属于中度或高轨迹组。

每月评估时,大多数BCS报告FCR水平波动。分步护理模式应在提供针对性干预之前多次评估FCR。

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