The Relationship of Illness Representations and Coping to Fear of Recurrence in Breast Cancer Patients.

Abstract

BACKGROUND: Breast cancer survivors are a large and growing cohort of women who are in need of ongoing follow-up care to monitor for latent physical effects of treatment, recurrence of disease, and evaluation/treatment of psychological needs. Fear of cancer recurrence (FCR) after treatment for breast cancer is studied infrequently, even though it may be causing significant distress in breast cancer survivors. PURPOSE: The purposes of this study were to: 1) build scientific understanding of FCR, as an independent construct, by exploring the relationships of patient characteristics (demographics and disease), illness representations, and coping to FCR in women survivors of breast cancer and 2) to explore who frequents Internet communities of breast cancer survivors while also examining the successes and pitfalls of recruitment and study design when using participants from Internet discussion boards and/or forums. THEORETICAL FRAMEWORK: This study was guided by the Common Sense Model of Illness Representations. METHODS: This study used a cross-sectional descriptive correlational design obtaining data from a web-based survey of standardized measures with acceptable reliabilities. One hundred and seven women recruited from three Internet discussion boards participated. Pearson correlations, hierarchical and stepwise regression analysis were used to explore the relationships between the study variables and FCR. RESULTS: This study found that fear of cancer recurrence was related to emotional representations, perceived consequences/severity, symptom attribution, perceived self-risk of a recurrence, and coping. It also found that the Internet was a useful, cost effective, though time-consuming way to recruit and study breast cancer survivors. CONCLUSIONS: FCR is an ongoing concern for breast cancer survivors in need of continued research. Evaluation of its multifactorial nature is needed to assist healthcare professional who specialize in survivorship care to understand the concept and to assist survivors with FCR to manage it. The Internet can be a rich source for recruitment into health sector research and with careful design and different approaches more expanded generalizable results are possible.