Examining Predictors of Fear of Cancer Recurrence Using Leventhal's Commonsense Model Distinct Implications for Oncology Nurses

Background Fear of cancer recurrence (FCR) is a common concern for survivors. Oncology nurses have a unique opportunity to identify survivors at increased risk of heightened FCR. Understanding predictors of FCR would be useful for this purpose; however, results about FCR predictors are inconsistent. Objective To examine empirically inconsistent predictors of FCR as guided by Leventhal's Commonsense Model. Methods A cross-sectional survey design was used to assess FCR, sociodemographic and clinical characteristics, and characteristics of the self (self-esteem and generalized expectancies) among cancer survivors. Structural equation modeling was used to examine predictors of FCR. Results Among 1001 participants, the mean time since diagnosis was 9.07 years, and most were diagnosed with breast cancer (65.93%). The strongest predictor of higher FCR was belief that knowing someone with a recurrence affects one's own level of FCR, although knowing someone with a recurrence actually predicted lower FCR. Other significant predictors of higher FCR were having 1 or more symptoms attributed to cancer, lower self-esteem, younger age, female gender, lower pessimism, longer time since diagnosis, and active follow-up at the survivorship clinic. Conclusion Cancer survivors' perceptions are among an important series of variables that may predict higher levels of FCR. Oncology nurses are uniquely situated to identify the subset of cancer survivors with levels of FCR requiring professional intervention. Implications for Practice Oncology nurses can use the predictors indicated in this study to identify survivors with greatest need for coping with FCR to facilitate expedient intervention and/or referral to psychosocial providers.

Automated summary

This study examined predictors of fear of cancer recurrence (FCR) among cancer survivors, finding that cognitive factors, symptoms, self-esteem, age, gender, pessimism, time since diagnosis, and other factors were significantly associated with FCR. Oncology nurses can use these predictors to identify survivors in need of intervention for coping with FCR.