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abstract:
When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence
Purpose
Fear
of cancer recurrence (FCR) is a common experience for cancer survivors.
However, it remains unclear what characteristics differentiate
non-clinical from clinical levels of FCR. The goal of this study was to
investigate the potential hallmarks of clinical FCR.
Methods
A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311–321. doi: 10.1007/s11136-015-1088-2, 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481–491. doi:10.1007/s11764-015-0424-4, 2015)
was used to identify participants with non-clinical and clinical FCR
and qualitative analysis of these interviews was performed.
Results
Individuals
with clinical FCR reported the following features: death-related
thoughts, feeling alone, belief that the cancer would return,
experiencing intolerance of uncertainty, having cancer-related thoughts
and imagery that were difficult to control, daily and recurrent, lasted
30 minutes or more, increased over time, caused distress and impacted
their daily life. Triggers of FCR and coping strategies did not appear
to be features of clinical FCR as they were reported by participants
with a range of FCR scores.
Conclusions
While
features of clinical FCR found in this analysis such as intrusive
thoughts, distress and impact on functioning confirmed previous FCR
research, other features spontaneously emerged from the interviews
including “death-related thoughts,” “feeling alone,” and “belief that
the cancer will return.” The participants’ descriptions of
cancer-specific fear and worry suggest that FCR is a distinct phenomenon
related to cancer survivorship, despite similarities with psychological
disorders (e.g., Anxiety Disorders). Future research investigating the
construct of FCR, and the distinguishing features of clinical FCR across
a range of cancer types and gender is required.
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