Psychological Resilience, Metacognitions, and Fear of Recurrence Among Cancer Survivors and Family Caregivers

Abstract

Background: Cancer is a life crisis that can have devastating consequences not only on the affected individual but also on his/her caregivers. Objective: The aim of this study was to investigate the influence of psychological resilience and metacognitions of cancer survivors and their family caregivers (FCs) on fear of recurrence (FoR). Methods: This study used a cross-sectional design while adhering to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Data were collected from 112 cancer survivors and 112 FCs recruited from 5 oncology hospitals. Results:The cancer survivors and caregivers reported low levels of psychological resilience, which we found to be correlated with great fear of recurrence in cancer survivors and FCs. It was also in relation with metacognitions in cancer survivors and FCs. The findings showed that psychological resilience negatively predicted the fear of recurrence, whereas the metacognitions positively predicted the fear of recurrence in cancer survivors and FCs.The total effects of psychological resilience on the FoR in cancer survivors and FCs were 0. 920 (confidence interval [CI], −2.059 to 0.072) and 0.061 (CI, −0.475 to 0.474), respectively. The total effects of metacognition on the FoR in cancer survivors and FCs were 1.164 (CI, 0.217-2.371) and 0.486 (CI, 0.016-1.058), respectively. Conclusions:The findings underline the direct and indirect mediating role of psychological resilience and metacognition of cancer survivors and FCs on FoR.Implication for Practice: The findings are particularly important to oncology nurses, who as 24-hour care providers are important sources of psychosocial care. Their awareness of factors influencing FoR is critical for achieving positive outcomes.

Metacognitive Processes in Cancer: A Review

“…We found two studies assessing metacognitive beliefs in caregivers indicating both positive and negative metacognitive beliefs are associated with subjective well-being 33 and psychological resilience. 37 Therefore, it is important to address metacognitive beliefs of caregivers and help them in dealing with the stressful situation and improving their quality of life.…”

“…35,36 A study reported psychological resilience in patients is low due to firm negative meta beliefs that predict fear of cancer recurrence (FCR) in patients. 37,38 Negative metacognitive beliefs partially mediate the relationship between neuroticism and fear of cancer recurrence, 39 suggesting that neuroticism and negative metacognition are positively associated. Patients with higher neuroticism are predisposed to experience negative beliefs about worry which increases their fear for cancer recurrence.…”

Relation Between Maladaptive Metacognitive Beliefs and Burden in Caregivers of Psychiatric Patients: Role of Resilience as a Moderator and Rumination as a Mediator

“…Resilience alludes to the process and the outcome of successful adaption to difficult or challenging life experiences, particularly through the mental, emotional, and behavioral flexibility and adjustment to external and internal demands. As concluded by preceding studies, persons with high level of psychological resilience have ability to cope with problems without a decrease in their functionality and with minimal or no psychosocial impact (Su, Liu, Li &Chen, 2020) , on the other hand, negative experiences such as inability to cope effectively with the difficulties experiences, inadequacy in solving the problems, and having chronic stress levels can be related to low psychological resilience levels (Abd El-Ghafar, Abd El-Nabi & Fathalla, 2018;Ağaç & Üzar-Özçetin, 2022).…”

Impact of early palliative care on the quality of life in caregivers of cancer patients: A systematic review

“…Cancer is one of the leading causes of death globally (Ferlay et al, 2020; World Health Organization [WHO], 2022), and a diagnosis usually has a devastating impact on patients and caregivers (Ağaç & Üzar‐Özçetin, 2022; Woźniak & Izycki, 2014). Cancer patients are burdened by the adverse implications of signs and symptoms associated with the disease (Nayak et al, 2017).…”