Fear of progression in breast cancer patients—validation of the short form of the Progredienzangstfragebogen PA-F-KF (Fear of Progression Questionnaire; FoP-Q-SF)
ABSTRACT Fear of progression is one of the most prevalent symptoms in cancer patients. The aim of this study was to validate the 12-item short version of the Fear of Progression Questionnaire (FoP-Q-SF).
A total of 1083 breast cancer patients were recruited by the Hamburg Cancer Register to fill out various questionnaires (response rate 67 %).
Estimates of reliability were high (Cronbach's alpha = .87). The original one-factor structure was replicated. We used the HADS, the PCL-C, and the SF-8, among others, to validate the FoP-Q-SF. Significant positive correlations were found for fear of progression, anxiety and intrusion (r > .60) as well as for avoidance, hyperarousal and depression (r > or = .49). Moderate to high (negative) correlations were observed with health-related quality of life, in particular with the mental health dimensions (r > or = .48). Patients with cancer recurrence reported significant higher levels of fear of progression (p < .001).
The short form of the Fear of Progression Questionnaire appears to be a reliable and valid instrument which can be recommended for further use in research and clinical care.
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ABSTRACT: Cancer patients often experience distress. However, the majority of newly diagnosed patients gradually adapt to the crisis. When symptoms of distress and anxiety persist over months, patients require psychosocial support. The aim of the present study was to determine the proportion of cancer patients who indicate the need for psychosocial support and to identify sociodemographic, psychological and illness-related factors predicting the need for psychosocial support in a German sample. The cross-sectional retrospective study was administered to 710 cancer patients who had been inpatients at the University Hospital of Cologne. The response rate was 49.5%. Patients suffering from bronchial, oesophageal, colorectal, breast, prostate and skin cancer participated in the study. The severity of depressive symptoms was assessed using the German version of the Major Depression Inventory. The level of anxiety was assessed with the state subscale of the German version of the State-Trait Anxiety Inventory. To measure the functional aspects of health-related quality of life, the scales "physical functioning", "role functioning", "emotional functioning", "cognitive functioning" and "role functioning" of the European Organisation for Research and Treatment of Cancer QLQ-C30 Questionnaire (EORTC QLQ-C30) were used. Of the cancer patients, 18.9% indicate an unmet need for psychosocial support and 9.5% are actually using psychosocial services. In a multiple logistic regression, significant indicators of the need for psychosocial support are gender [p = 0.014; standardised effect coefficient (sc) = 1.615] and emotional functioning (p < 0.001; sc = 1.533). The estimated model has a specificity of 92.2% and a sensitivity of 54.0%. Almost a third of the cancer patient population indicates an unmet need for psychosocial support or is actually using psychosocial services. Emotional functioning is a central predictor of the requirement for psychosocial support. Women are emotionally more affected than men and need more psychosocial support. The prognostic validity of the severity of depression and anxiety is limited.Supportive Care in Cancer 03/2009; 17(11):1417-23. DOI:10.1007/s00520-009-0605-7 · 2.36 Impact Factor
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ABSTRACT: This paper aims to evaluate the effects of two psychotherapeutic interventions on dysfunctional fear of progression (FoP) in cancer patients and to investigate illness-specific influences. One hundred seventy-four cancer patients were recruited from two rehabilitation clinics and randomly assigned to either a four-session cognitive-behavioral group therapy or a supportive-experiential group therapy. The main outcome criterion was FoP that was assessed with the Fear of Progression Questionnaire (FoP-Q) directly before (T1) and after (T2) the intervention, as well as 3 (T3) and 12 months (T4) after discharge. Secondary outcomes were anxiety, depression, and quality of life that were assessed with the following questionnaires: Questions on Life Satisfaction, Questionnaire for General Health Status, and the Hospital Anxiety and Depression Scale. Patients from the control group (n = 91) who received treatment as usual were recruited 1 year later with the same inclusion criteria and assessed with the FoP-Q at T1, T2, and T4. Analyses showed a significant main effect for time and a significant interaction for group x time for the main outcome variable. FoP decreased significantly over time in both intervention groups in contrast to the control group that showed only short-term improvements. The interventions were also effective in improving secondary outcomes except general life satisfaction. Analyses of cancer specific influences on FoP indicated a significant influence of disease status, i.e., patients with metastases and recurrence of cancer gained most from the interventions. Fear of progression, one of the main sources of distress for cancer patients, can be reduced with short psychotherapeutic interventions.Supportive Care in Cancer 10/2009; 18(4):471-9. DOI:10.1007/s00520-009-0696-1 · 2.36 Impact Factor
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ABSTRACT: To assess the character and frequency of fear of progression (FoP) and to clarify its relationship with cancer-related intrusive cognitions in breast cancer survivors. A sample of 1083 patients was recruited in this cross-sectional study through a population-based Cancer Registry an average of 47 month following diagnosis (66% response rate). Participants completed self-report measures assessing fear of cancer progression (FoP-Q-SF), posttraumatic stress-disorder symptoms (PCL-C), coping strategies (DWI) and quality of life (QoL) (SF-8). In total, 23.6% of women were classified as having moderate to high FoP. Being nervous prior to doctors' appointments or examinations and being afraid of relying on strangers for activities of daily living were the most frequent fears. FoP was significantly associated with younger age, having children, disease progress, chemotherapy, perceived amount of impairments, physical and mental QoL, but not with time since initial diagnosis. Intrusive cognitions were screened in 37% of the sample. We found significant correlations between FoP and intrusive thoughts (r=0.63), avoidance (r=0.57), hyperarousal (r=0.54) and posttraumatic stress disorder diagnosis (r=0.42). Factors significantly associated with moderate and high FoP included a depressive coping style as well as an active problem-oriented coping style, intrusion, avoidance and hyperarousal symptoms (Nagelkerke's R(2)=0.44). Findings of this study give information regarding the frequency and the character of anxiety in breast cancer survivors and underline the relation of FoP to the reality of living with breast cancer. Results suggest that intrusive cognitions as well as avoidance and hyperarousal symptoms seem to be closely related to future-oriented fears of cancer recurrence.Psycho-Oncology 12/2009; 18(12):1273-80. DOI:10.1002/pon.1481 · 2.44 Impact Factor