Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

Ng, Danielle Wing Lam; Kwong, Ava; Suen, Dacita; Chan, Miranda; Or, Amy; Ng, Siuman Simon; Foo, Chi Chung; Fielding, Brenna F.S.; Lam, Wendy Wing Tak

doi:10.1002/pon.5073

Cited by 34 publications

(42 citation statements)

References 36 publications

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“…In these studies, data were generally presented as mean FCRI-total scores, and/or mean FCRI-SF scores, and/or as percentages using the FCRI-SF cut-offs of ≥13, 6,7,30-32,33-36 ≥16 17,33,37,38 or ≥22. 36,37 See Table 1 for further details. FCRI-total scores (score range 0-168) were reported in 25 studies, with mean scores ranging from 39.8 in a sample of prostate cancer survivors 11 to 113.5 in a sample of gynecological cancer survivors. 39 The reported standard deviations ranged from 18.6 to 39.5 with an average of 28.2, samples sizes varied from 27 to 1984 and the mean time since diagnosis ranged from 4.1 months to 16.5 years.…”

Section: Fcr Severity and Prevalence According To The Fcrimentioning

confidence: 99%

“…FCR Correlates According to the FCRI The FCRI has been used to evaluate various demographic, clinical, and psychosocial correlates of FCR. Variables commonly associated with higher FCR in these studies include younger age; 30,36,43,44 female gender; 36,44,45 pain; 45,46 poor sleep 37 or fatigue; 45 and higher anxiety and depression. 43,47,48 There is some indication that the levels of FCR may vary by cancer diagnosis; 30,45 however, further clarification is necessary as no systematic comparisons taking other between-sample differences into consideration have been conducted.…”

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confidence: 96%

“…A surprisingly small proportion of studies reported the percentages of patients with scores taken to indicate clinical FCR. As seen in Table 1, in the nine studies 6,7,[30][31][32][33][34][35][36] using ≥13 on the FCRI-SF as a cutoff, more than half (53.9%) of participants scored above the cut-off. In the four studies 17,33,37,38 with data on the ≥16 cut-off, approximately 43.3% had scores indicating clinical levels of FCR.…”

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confidence: 99%

“…In the four studies 17,33,37,38 with data on the ≥16 cut-off, approximately 43.3% had scores indicating clinical levels of FCR. In the two samples 36,37 with data on the ≥22 cut-off, approximately one third (30%) had scores suggesting clinical levels of FCR.…”

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confidence: 99%

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Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

Smith¹,

Costa²,

Galica³

et al. 2020

PRBM

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Fear of cancer recurrence (FCR) is a pervasive concern for people living with cancer. The rapidly expanding FCR literature has been weakened somewhat by use of miscellaneous FCR measures of varying quality. The Fear of Cancer Recurrence Inventory (FCRI) has been widely used in observational and intervention studies and the FCRI severity subscale, also known as the FCRI-Short Form (FCRI-SF), is often used to identify potential cases of clinically significant FCR. Given the FCRI’s increasing use in research and clinical practice, we aimed to provide an overview, critique, and suggested improvements of the FCRI. Studies citing the original FCRI validation paper were identified and synthesised using narrative and meta-analytic methods. The 42-item FCRI has demonstrated a reasonably robust 7-factor structure across evaluations in multiple languages, although certain subscales (eg, Coping) demonstrate sub-optimal reliability. Confirmation of the cross-cultural equivalence of several FCRI translations is needed. Meta-analysis of FCRI-SF scores revealed a combined weighted mean score of 15.7/36, a little above the lowest proposed cut-off score (≥13) for clinical FCR. Depending on the FCRI-SF cut-off used, between 30.0% and 53.9% of the cancer population (ie, patients and survivors) appear to experience sub-clinical or clinical FCR. Higher FCRI scores were associated with younger age and female gender, pain/physical symptoms and psychological morbidity, consistent with the FCR literature generally. Issues regarding the application and interpretation of the FCRI remain. Whether the FCRI is well suited to assessing fear of progression as well as recurrence is unclear, the meaningfulness of the FCRI total score is debatable, and the use of the FCRI-SF to screen for clinical FCR is problematic, as items do not reflect established characteristics of clinical FCR. Refinement of the FCRI is needed for it to remain a key FCR assessment tool in future research and clinical practice.

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Section: Fcr Severity and Prevalence According To The Fcrimentioning

confidence: 99%

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confidence: 96%

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confidence: 99%

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confidence: 99%

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Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

Smith¹,

Costa²,

Galica³

et al. 2020

PRBM

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“…Several studies examined metacognition in FCR, support the utility of the S‐REF model in cancer contexts . For example, positive correlations between different metacognitive beliefs and FCR were reported among young breast cancer (BC) survivors .…”

Section: Introductionmentioning

confidence: 99%

The role of metacognition and its indirect effect through cognitive attentional syndrome on fear of cancer recurrence trajectories: A longitudinal study

Foo

et al. 2019

Psycho-Oncology

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Objective: This longitudinal study mapped distinct trajectories of fear of cancer recurrence (FCR) over 12 months among patients with breast (BC) or colorectal (CRC) cancer, and examined if metacognition, indirectly via attentional bias, intrusive thoughts and avoidance (hallmarks of cognitive attentional syndrome; CAS) predicted FCR trajectory membership. Methods: Two hundred and seventy BC (n = 163) or CRC (n = 107) patients were assessed at 8-weeks, 3-, 6-, and 12-months postsurgery on a measure of FCR (FCRI-SF). Metacognition (MCQ-30), Intrusive and Avoidant Thoughts (CIES-R) and attentional bias (dot-probe tasks) were assessed at baseline. Latent growth mixture modeling identified FCR trajectories. Fully-adjusted Multinomial Logistic Regression identified whether direct and indirect effects of metacognition through CAS determined FCR trajectory membership.Results: Three distinct FCR trajectories were identified, namely, low-stable (62.4%), high-stable (29.2%), and recovery (8.3%). Negative beliefs about worry, cognitive confidence, and age predicted FCR trajectories (χ 2 (6) = 38.31, P<.001). Compared with Low-stable group, Recovery FCR patients held greater Negative beliefs about worry (OR = 1.13, P = .035) and High-stable FCR patients reported poorer Cognitive confidence (OR = 1.12, P = .004). The effect of Negative beliefs about worry was partially mediated by avoidance (β = .06, 95% CIs 0.03-0.12) and fully mediated by intrusive thoughts (β = .14, 95% CIs 0.08-0.20). Attentional bias did not predict FCR trajectories.Conclusions: While most patients experienced low level of FCR, 3 in 10 persistently worried about cancer returning over the first 12-months postsurgery. Modifying metacognitive knowledge to interrupt maladaptive cognitive processing including intrusion and avoidance may be an effective therapeutic intervention for patients at risk of persistent FCR. K E Y W O R D Sattentional bias, avoidance, fear of cancer recurrence trajectory, intrusive thoughts, meta-cognition

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Mindfulness facets predict quality of life and sleep disturbance via physical and emotional distresses in Chinese cancer patients: A moderated mediation analysis

Fong

2020

Psycho-Oncology

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ObjectiveColorectal cancer survivors are at risk of symptom burden and emotional distress. Dispositional mindfulness has been linked with better sleep quality and quality of life (QoL) in these patients. This longitudinal study aimed to examine the associations among mindfulness facets, symptom burden, emotional distress, and functional outcomes.MethodsStudy sample of this three‐wave, 2‐month survey was 127 Chinese colorectal cancer survivors. The participants completed the Five Facet Mindfulness Questionnaire, Memorial Symptom Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and SF‐12 health survey. Moderated mediation analyses examined the direct and indirect effects of mindfulness facets on QoLs and sleep quality via symptom burden and emotional distress, using acting with awareness as a moderator.ResultsThe mindfulness facets had no significant direct effects on functional outcomes 2 months later. Awareness and nonreacting showed significant and positive indirect effects on physical and mental QoL via symptom burden and emotional distress 1 month later, respectively. Awareness, nonjudging, and nonreacting significantly predicted better sleep quality indirectly via emotional distress. Nonreacting showed stronger indirect effects on the functional outcomes among patients with greater awareness.ConclusionsThis study demonstrates longitudinal linkages between dispositional mindfulness and functioning in cancer survivors via symptom burden and emotional distress. Acting with awareness and nonreacting are the two facets that displayed clinical relevance in predicting better sleep quality and QoL.

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Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism

Cited by 34 publications

References 36 publications

Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

Spotlight on the Fear of Cancer Recurrence Inventory (FCRI)

The role of metacognition and its indirect effect through cognitive attentional syndrome on fear of cancer recurrence trajectories: A longitudinal study

Mindfulness facets predict quality of life and sleep disturbance via physical and emotional distresses in Chinese cancer patients: A moderated mediation analysis

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