School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
Psycho-Oncology Co-operative Group (POCOG), The University of Sydney, Sydney, Australia.
Health Psychol Rev. 2023 Jun;17(2):301-320. doi: 10.1080/17437199.2022.2039744. Epub 2022 Feb 18.
Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has rarely been studied outside of the cancer context. This review aimed to: (1) meta-synthesise qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e., seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses.
对癌症复发的恐惧 (FCR) 是癌症幸存者中最常见的心理社会问题。然而，除了癌症之外，对进展的恐惧 (FoP) 很少被研究。本综述旨在：(1) 综合分析除癌症以外的疾病中 FoP 的定性研究；(2) 定量研究非癌症慢性疾病中 FoP 与焦虑、抑郁和生活质量 (QoL) 的关系。我们在一系列慢性疾病中确定了 25 项定性研究和 11 项定量研究。参与者描述了对疾病进展和复发的恐惧，包括对死亡的恐惧和对成为家庭负担的恐惧。恐惧通常是由向下比较（即，看到比自己更糟糕的人）引发的。参与者以不同的方式应对，包括接受疾病或寻求知识。那些因这些恐惧而感到困扰的人报告说对身体症状高度警惕并回避。痛苦和寻求信息与依从性有关。在定量分析中，FoP 与 QoL 中度相关，与焦虑和抑郁强烈相关。这些结果表明，除癌症以外的疾病中的 FoP 与 FCR 相似。FoP 似乎是一个与痛苦相关的重要跨诊断结构。可以根据 FCR 的循证干预措施进行调整，以更好地管理其他疾病中的 FoP。
