School of Nursing, Fujian Medical University, Fuzhou, China.
Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
J Clin Nurs. 2024 Apr;33(4):1409-1420. doi: 10.1111/jocn.16922. Epub 2023 Oct 31.
To investigate the trajectory, influencing factors and dynamic relationships between fear of cancer recurrence (FCR) and quality of life (QOL) in lung cancer patients.
Prospective longitudinal study.
Longitudinal data from 310 lung cancer patients across three hospitals in China were assessed at 1, 3, 6 and 12 months postoperatively (T -T ). Descriptive statistics characterised patient demographics, clinical characteristics, levels of FCR and QOL. A linear mixed-effects model was employed to analyse FCR trajectories, identify influencing factors on these trajectories, and predict the impact of FCR on QOL.
FCR changed significantly over time, with a slight decrease during T -T , an increase at T and gradual decline at T . Higher fear levels were associated with female sex, suburban or rural residency, being a family breadwinner, presence of comorbidities and negative coping behaviours, and low family resilience. QOL negatively correlated with FCR, and FCR predicted lower QOL.
At 3 and 6 months postoperatively, lung cancer patients, especially women, suburban or rural residents, family breadwinners, those with comorbidities, negative coping behaviours and low family resilience, reported high levels of FCR. Healthcare providers should pay special attention to lung cancer patients especially during the period of 3-6 months post-surgery and offer tailored interventions to improve their QOL.
Understanding the FCR trajectories, its influencing factors and its negative impacts on QOL can guide the development of targeted interventions to reduce fear and enhance well-being in patients with cancer.
Identifying the trajectories and influencing factors of fear of lung cancer recurrence in patients at different time points informs future research on targeted interventions to improve QOL.
The study adhered to the guidelines outlined in the Statement on Reporting Observational Longitudinal Research.
探讨肺癌患者恐惧癌症复发（FCR）和生活质量（QOL）的轨迹、影响因素及动态关系。
前瞻性纵向研究。
在中国 3 家医院的 310 例肺癌患者的纵向数据在术后 1、3、6 和 12 个月（T-T ）进行评估。描述性统计分析了患者人口统计学、临床特征、FCR 和 QOL 水平。采用线性混合效应模型分析 FCR 轨迹，确定影响这些轨迹的因素，并预测 FCR 对 QOL 的影响。
FCR 随时间显著变化，T-T 期间略有下降，T 时增加，T 时逐渐下降。较高的恐惧水平与女性、郊区或农村居住、家庭顶梁柱、合并症和消极应对行为以及家庭适应能力差有关。QOL 与 FCR 呈负相关，FCR 预测 QOL 较低。
术后 3 个月和 6 个月时，肺癌患者，尤其是女性、郊区或农村居民、家庭顶梁柱、有合并症、消极应对行为和家庭适应能力差的患者，报告 FCR 水平较高。医疗保健提供者应特别关注肺癌患者，特别是在术后 3-6 个月期间，并提供量身定制的干预措施，以提高他们的 QOL。
了解 FCR 的轨迹、影响因素及其对 QOL 的负面影响可以指导针对癌症患者的靶向干预措施的发展，以减少恐惧并提高幸福感。
确定不同时间点肺癌患者恐惧复发的轨迹和影响因素，为未来针对改善 QOL 的靶向干预措施的研究提供信息。
本研究遵循观察性纵向研究报告指南。
