Examining Fear of Recurrence in Cancer Survivors

Examining Fear of Recurrence in Cancer Survivors by Christina L. Dixon MA, The Chicago School of Professional Psychology, 2012 BS, Eastern Oregon University, 2010 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University February 2019 Abstract Improvements in the medical field have given many cancer patients and survivors better odds of long-term survival. As more patients become survivors, the demand for psychological treatment becomes greater. The most prevalent concern of survivors is getting help with a psychosocial condition known as fear of recurrence (FOR). Prior to this study, few researchers had explored how having a more aggressive cancer influences the development of FOR. The purpose of this quantitative study was to determine whether cancer stage and type (a measurement of severity) are predictive of FOR development in the high-risk cancer groups lung and bronchus and female breast. The theoretical framework guiding this research was based on Mishel’s theory of uncertainty in illness, which states that uncertainties about illness recurrence can cause survivors to experience breakdown in their lives (whether psychological and/or physical). The fear of cancer recurrence inventory (FCRI) survey was administered to 97 lung and bronchus and female breast cancer survivors; the survivors were asked to rate their level of discomfort about the possibility of a cancer recurrence. Data were analyzed using multiple linear regression. The results indicated that cancer type and severity both impacted the development and severity of FOR in lung and bronchus and female breast cancer survivors. Furthermore, regardless of the cancer type, stage of cancer, age of the survivor, or years in remission, survivors reported clinical levels of FOR in all areas of concern. Practitioners can use the current findings to work towards developing better intervention and treatment programs that promote quality survivorship and reduce the risk and rate of FOR in high risk cancer populations.Improvements in the medical field have given many cancer patients and survivors better odds of long-term survival. As more patients become survivors, the demand for psychological treatment becomes greater. The most prevalent concern of survivors is getting help with a psychosocial condition known as fear of recurrence (FOR). Prior to this study, few researchers had explored how having a more aggressive cancer influences the development of FOR. The purpose of this quantitative study was to determine whether cancer stage and type (a measurement of severity) are predictive of FOR development in the high-risk cancer groups lung and bronchus and female breast. The theoretical framework guiding this research was based on Mishel’s theory of uncertainty in illness, which states that uncertainties about illness recurrence can cause survivors to experience breakdown in their lives (whether psychological and/or physical). The fear of cancer recurrence inventory (FCRI) survey was administered to 97 lung and bronchus and female breast cancer survivors; the survivors were asked to rate their level of discomfort about the possibility of a cancer recurrence. Data were analyzed using multiple linear regression. The results indicated that cancer type and severity both impacted the development and severity of FOR in lung and bronchus and female breast cancer survivors. Furthermore, regardless of the cancer type, stage of cancer, age of the survivor, or years in remission, survivors reported clinical levels of FOR in all areas of concern. Practitioners can use the current findings to work towards developing better intervention and treatment programs that promote quality survivorship and reduce the risk and rate of FOR in high risk cancer populations. Examining Fear of Recurrence in Cancer Survivors by Christina L. Dixon MA, The Chicago School of Professional Psychology, 2012 BS, Eastern Oregon University, 2010 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University February 2019 Dedication This dissertation is dedicated to my husband and son, Richard Satchwell and Mateo Satchwell, and my mother Ingrid Austin, for always believing in me and supporting me throughout the process. When times were tough, and I felt that all of this was too much, each of you taught me that the journey would not be worth it if it were not challenging. You never doubted my abilities even though I sometimes did. Thank you for keeping me on the path and giving me support along the way. I cannot thank you enough. You are appreciated beyond anything I can describe. I would also like to thank my deceased grandmother Martha Bruns and father Cornell Harrell Dixon for helping to build such a strong and dedicated woman. The both of you played a monumental part in my upbringing and perseverance. Without either of you, I would not be who I am today. I love all of you! Know that without you, there is no me! Acknowledgments The completion of this dissertation would not be possible without the support and help of many individuals. The number of eyes that have viewed this document is unbelievable. First, I give thanks to God for providing me with the strength, knowhow, and determination needed to be successful. There were many hiccups along the way but with you, family, and my team, anything seemed possible. I give thanks to Dr. Ellen Levine and Dr. Christopher K. Bass, both of whom acted as my committee chair at one point or another. The both of you have held my hand along the way, through good and bad. Without your unyielding support and knowledge, this journey would have been unbearable. The two of you not only helped me to see the finish line but continuously moved me towards it, no matter the obstacle. Thank you for your contribution to my success. Immeasurable thanks and appreciation to Dr. Simard and Dr. Savard, the Relay for Life committee of Guadalupe County, and the cancer survivors who were willing to share their concerns and experiences with me. You made this study possible! Without each of your contributions, this study would have never taken flight. Know that with all our combined efforts, we are making needed advancements in the psycho-oncology field, ones that could help to improve millions of cancer survivors’ quality of life. Thank you, a million times over, for being selfless and supportive!