Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia.
Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool, BC NSW, 1871, Australia.
J Cancer Surviv. 2024 Apr;18(2):425-438. doi: 10.1007/s11764-022-01233-9. Epub 2022 Jul 25.
Approximately 50% of cancer survivors experience moderate-severe fear of cancer recurrence (FCR). Self-guided digital interventions have potential to address the high level of FCR-related unmet needs at scale, but existing digital interventions have demonstrated variable engagement and efficacy. This study aimed to evaluate the feasibility and preliminary efficacy of iConquerFear, a five-module self-guided digital FCR intervention.
Eligible curatively treated breast cancer survivors were recruited. Participants reporting clinically significant FCR (≥ 13 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were given access to iConquerFear. Feasibility was indicated by > 50% of eligible participants enrolling in iConquerFear and recording moderate (≥ 120 min) or greater usage. Preliminary efficacy was evaluated via changes in self-reported FCR severity, anxiety, depression, intrusions and metacognitions from baseline to immediately and 3 months post-intervention.
Fifty-four (83%) of 65 eligible participants enrolled in iConquerFear; six subsequently withdrew. Thirty-nine (83%) participants recorded moderate (n = 24; 120-599 min) or high (n = 15; ≥ 600 min) usage. Engagement levels increased with participant age (p = 0.043), but were lower in participants with higher baseline FCR (p = 0.028). Qualitative feedback indicated engagement was sometimes limited by difficulties with navigation and relating to featured survivors. Participants reported significantly improved FCR (mean reduction (95%CI): baseline to post-intervention - 3.44 (- 5.18, - 1.71), baseline to 3-month follow-up - 4.52 (- 6.25, - 2.78), p = < 0.001).
iConquerFear is a feasible and potentially efficacious intervention for reducing FCR in breast cancer survivors. Easier navigation and more relatable examples may enhance engagement.
iConquerFear may help address moderate but burdensome FCR levels in cancer survivors.
约 50%的癌症幸存者经历中度至重度的癌症复发恐惧（FCR）。自我指导的数字干预有可能大规模解决 FCR 相关的大量未满足的需求，但现有的数字干预措施的参与度和效果各不相同。本研究旨在评估 iConquerFear 的可行性和初步疗效，iConquerFear 是一个五模块的自我指导的数字 FCR 干预。
招募了符合条件的接受治愈性治疗的乳腺癌幸存者。报告有临床显著 FCR（恐惧癌症复发量表-短表（FCRI-SF）≥13）的参与者被给予 iConquerFear 的访问权限。可行性由超过 50%的合格参与者登记参加 iConquerFear 并记录中等（≥120 分钟）或更高的使用情况来表示。通过从基线到干预后立即和 3 个月时自我报告的 FCR 严重程度、焦虑、抑郁、侵入和元认知的变化来评估初步疗效。
65 名符合条件的参与者中，有 54 名（83%）登记参加了 iConquerFear；随后有 6 名退出。39 名（83%）参与者记录了中等（n=24；120-599 分钟）或高（n=15；≥600 分钟）的使用量。参与度随着参与者年龄的增加而增加（p=0.043），但在基线 FCR 较高的参与者中较低（p=0.028）。定性反馈表明，参与度有时受到导航困难和与特色幸存者的关系的限制。参与者报告 FCR 显著改善（平均减少（95%CI）：从基线到干预后-3.44（-5.18，-1.71），从基线到 3 个月随访-4.52（-6.25，-2.78），p<0.001）。
iConquerFear 是一种可行且可能有效的干预措施，可用于降低乳腺癌幸存者的 FCR。更简单的导航和更具相关性的示例可能会提高参与度。
iConquerFear 可能有助于解决癌症幸存者中中度但负担沉重的 FCR 水平。
