School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia.
Psychooncology. 2023 Aug;32(8):1173-1191. doi: 10.1002/pon.6176. Epub 2023 Jun 11.
Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures.
CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906).
Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most.
Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
癌症幸存者和照顾者都报告了对癌症复发的恐惧（FCR），但对照顾者 FCR 的了解较少。本研究旨在：（a）进行荟萃分析以比较幸存者和照顾者 FCR 水平；（b）研究照顾者 FCR 与抑郁和焦虑之间的关系；（c）评估照顾者 FCR 测量的心理测量特性。
在 CINAHL、Embase、PsychINFO 和 PubMed 中搜索定量研究，以检查照顾者 FCR。纳入标准包括照顾患有任何类型癌症的幸存者、报告照顾者 FCR 和/或测量结果、以英文发表、同行评审期刊，发表时间为 1997 年至 2022 年 11 月。使用共识基础健康状况测量工具选择标准（COSMIN）分类法评估内容和心理测量特性。该综述已预先注册（PROSPERO ID：CRD42020201906）。
在筛选出的 4297 条记录中，有 45 条符合纳入标准。荟萃分析表明，照顾者报告的 FCR 水平与幸存者的 FCR 水平一样高，约 48%的照顾者报告存在临床显著的 FCR 水平。焦虑和抑郁与幸存者 FCR 之间存在较强的相关性，与幸存者 FCR 之间存在中度相关性。有 12 种不同的工具用于测量照顾者 FCR。使用 COSMIN 分类法评估发现，很少有工具经过适当的开发和心理测量测试。只有一种工具符合 50%或更多的标准，这表明大多数工具都缺少实质性的开发或验证部分。
结果表明，FCR 对照顾者来说是一个问题，就像对幸存者一样。与幸存者一样，照顾者 FCR 与更严重的抑郁和焦虑有关。照顾者 FCR 的测量主要依赖于幸存者的概念和未经验证的测量方法。迫切需要更多针对照顾者的研究。
