Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Psychooncology. 2023 Sep;32(9):1424-1432. doi: 10.1002/pon.6193. Epub 2023 Jul 25.
Fear of cancer recurrence (FCR) is a distressing concern among cancer survivors. Interventions to address FCR need to be effective but also accessible and low cost. This randomized controlled trial evaluated the efficacy of an online group-based psychological intervention for FCR (ConquerFear-Group).
Eligible breast cancer (BC) survivors had completed primary treatment 3 months-5 years previously, were ≥18 years, and scored ≥22 on the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). Participants were randomized to online ConquerFear-Group (focusing on metacognitive strategies, values-clarification, and education about follow-up behavior) or online group-based relaxation training (active control). Questionnaires were completed at baseline (T1), 1 week post-intervention (T2), three (T3) and six (T4) months later. The primary outcome was FCR (FCRI total). A number of secondary and process outcomes were also collected. Treatment effects were evaluated with mixed linear models.
Of 866 eligible BC survivors, 475 (55%) completed the FCR screening, and 85 (18%) were randomized to ConquerFear-Group or relaxation training (2 × 6 groups). Compared with control participants, ConquerFear-Group participants experienced larger reductions in FCR (Cohen's d = 0.47, p = 0.001) and FCR severity (d = 0.57, p < 0.001), as well as mindfulness and decentering from baseline through follow-up, and improvements in emotion regulation (T2), worry (T2, T3) and rumination (T2) at some time points.
The results demonstrated statistically significant and stable effects of ConquerFear-Group on FCR that were maintained over a 6-month period. It is suggested to investigate the program in a real-life setting, where a pragmatic trial can further demonstrate feasibility and effectiveness.
癌症复发恐惧（FCR）是癌症幸存者的一种痛苦担忧。解决 FCR 的干预措施需要有效，但也需要易于获得且成本低廉。这项随机对照试验评估了一种针对 FCR 的在线基于小组的心理干预（ConquerFear-Group）的疗效。
符合条件的乳腺癌（BC）幸存者在完成主要治疗后 3 至 5 年内，年龄≥18 岁，且在恐惧癌症复发量表-短式（FCRI-SF）上得分为≥22。参与者被随机分配到在线 ConquerFear-Group（专注于元认知策略、价值观澄清和后续行为教育）或在线基于小组的放松训练（主动对照）。在基线（T1）、干预后 1 周（T2）、3 个月（T3）和 6 个月（T4）时完成问卷。主要结局指标是 FCR（FCRI 总分）。还收集了一些次要和过程结局。使用混合线性模型评估治疗效果。
在 866 名符合条件的 BC 幸存者中，有 475 名（55%）完成了 FCR 筛查，85 名（18%）被随机分配到 ConquerFear-Group 或放松训练（2×6 组）。与对照组参与者相比，ConquerFear-Group 参与者的 FCR（Cohen's d=0.47，p=0.001）和 FCR 严重程度（d=0.57，p<0.001）显著降低，以及从基线到随访的正念和去中心程度，以及情绪调节（T2）、担忧（T2、T3）和沉思（T2）在某些时间点得到改善。
结果表明 ConquerFear-Group 对 FCR 具有统计学上显著且稳定的影响，且在 6 个月内保持稳定。建议在实际环境中对该方案进行研究，其中一项实用试验可以进一步证明其可行性和有效性。
