Fear of Breast Cancer Recurrence (Paperback)

Fear of cancer recurrence is a concern for 55% to 90% of breast cancer survivors. The purpose of this study was to identify the relationships among seven antecedent variables (i.e., perceived risk of recurrence, knowledge of someone with a recurrence, knowledge of recurrence signs and symptoms, trait anxiety, healthcare provider interaction at diagnosis, symptom bother and breast cancer reminder), three covariates (i.e., age at diagnosis, time since diagnosis, and treatment), and fear of recurrence while identifying the effects of four mediators (i.e., healthcare provider social support, healthcare provider social constraint, and healthcare provider interaction now, and breast cancer self-efficacy). In addition, the relationships among fear of recurrence and more distal outcome variables (i.e., post-traumatic growth, cancer-related distress, and well-being) were explored. Methods. A cross-sectional survey design was done using data within a larger quality of life parent grant. Correlations and regressions were used for the analysis. Results. Age at diagnosis and antecedents predicted 40.3% of the variance in fear of recurrence. Several antecedents significantly predicted fear of recurrence while controlling for age at diagnosis: perceived risk of recurrence, trait anxiety and breast cancer reminders. Breast cancer self-efficacy interacted with two antecedents; healthcare provider interaction at diagnosis and breast cancer reminders. Breast cancer self-efficacy suppressed variance around healthcare provider interaction at diagnosis allowing the relationship of healthcare provider interaction at diagnosis with fear of recurrence to become apparent. Breast cancer self-efficacy also partially mediated the effect of breast cancer reminders on fear of recurrence. Implications. Research implications included exploring fear of recurrence as a fear and antecedents that explained significant variance in fear of recurrence. Testing interactions among antecedents is needed to explain more variance in fear of recurrence. Practice implications included that fear of recurrence did not differ by time since diagnosis and that breast cancer self-efficacy mediated antecedent effects on fear of recurrence. Nurses are in a position to educate breast cancer survivors and healthcare colleagues about ongoing fear of recurrence in long term breast cancer survivors. Also, nurses are in a position to assess breast cancer survivors for predictors of fear of recurrence and to manage ramifications of long term fear of recurrence with breast cancer self-efficacy interventions.