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Objective: The Worries About Recurrence or Progression Scale (WARPS) was recently validated in four common chronic illnesses other than cancer, after a rigorous development process based on the COSMIN criteria. Available measures of fear of progression or fear of cancer recurrence (FCR) have been criticised for not meeting all COSMIN criteria. Therefore, this study aimed to explore the psychometric properties of the WARPS in a cancer sample to assess its applicability to measure FCR., Methods: We recruited 346 participants living with or beyond cancer for an online survey. The psychometric properties of the WARPS were examined using a confirmatory factor analysis. Convergent validity was assessed against the current gold standard questionnaires and constructs related to FCR. Some participants completed a follow-up survey 2 weeks later, to assess the test-retest reliability. Finally, a Receiver Operating Characteristics analysis was conducted to determine clinical cut-offs for the WARPS., Results: Confirmatory factor analysis confirmed that the WARPS has one underlying factor, fear of recurrence or progression (FRP), with adequate model fit. The WARPS demonstrated excellent internal consistency, test-retest reliability and showed convergent validity. ROC analysis revealed a cut-off of 54 for moderate, and 65 for severe FCR on the WARPS., Conclusions: The WARPS demonstrated good psychometric properties in a cancer sample. It has the capacity to be used as a screening tool to identify clinical levels of FCR. The WARPS was developed consistent with the COSMIN criteria and overcomes some of the limitations of existing measures., (© 2024 John Wiley & Sons Ltd.)

Background: The quality of life (QoL) of patients with pulmonary hypertension (PH) is severely compromised. Fear of progression (FoP) may be an important predictor of compromising the QoL in PH patients. Therefore, our study aimed to investigate the association between QoL and FoP among PH patients., Methods: A cross-sectional study comprising 255 patients was conducted using convenience sampling, using the Self-administered socio-demographic information questionnaire, the World Health Organization quality of life questionnaire abbreviated version, and the Chinese version of the Fear of Progression Questionnaire-Short Form. Network analysis was completed using R software., Results: In the current network model, the QoL in the psychological domain had the highest node centrality (strength = 1.155). The highest bridge centrality node was physiological health-related fear (bridge strength = 0.303). The edge between physiological health-related fear and social family-related fear has the highest strength (edge weights = 0.596)., Conclusions: This study revealed that the psychological domain of QoL is likely to be the most dominant in the overall QoL of PH patients. It can serve as a primary focus for QoL management strategies to improve the overall QoL of PH patients. Furthermore, physical health-related fear is an urgent mental health concern to be alleviated in PH patients' FoP. As a bridge variable, physical health-related fear can be used as a potential clinical intervention target for developing and utilizing intervention programs to alleviate the FoP in PH patients, which may help maintain or even enhance the psychological and overall QoL of PH patients., Competing Interests: Declarations. Ethics approval and consent to participate: All methods of this study were carried out in accordance with Reporting Standards for Psychological Network Analyses in Cross-Sectional Data and the Declaration of Helsinki. All methods were approved by the Ethics Committee of Scientific Research of the School of Nursing and Rehabilitation of Shandong University (approval number is 2021-R-154). Informed consent was obtained from all participants involved in the current study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Objective: In this study, we investigated the fear of disease progression in Chinese PBT patients and examined the correlation between sociodemographic, clinical, and psychological variables of patients with the fear of progression (FoP). Additionally, the study also evaluated the subjective experience of FoP in patients with primary brain tumors (PBT)., Methods: A mixed-methods study was conducted between March 2022 and December 2023, consisting of two phases: a quantitative approach in phase I, and a qualitative approach in phase II. In phase I, 305 patients with PBT filled in several questionnaires. An analysis was performed to identify potential predictors associated with FoP. In phase II, semi-structured interviews were conducted with 16 participants whose FoP scores were ≥ 34 in phase I to obtain information on their personal experiences with FoP., Results: The results of the quantitative study showed that 192 (63 %) patients experienced high levels of FoP. The mean score of fear of progression was (34.02±6.78). Young age, high disease uncertainty, low social support, high negative coping and low positive coping are important factors affecting FoP in PBT patients. Qualitative research focused on three themes: triggers, coping styles, and the help needed., Conclusion: Enhanced screening and assessment of FoP is essential to identify dysfunctionin PBT. Meanwhile, the implications of these predictors for enhanced healthcare professional education and patient self-management may help healthcare providers implement relevant interventions promptly and help patients reduce their FoP. However, due to limitations such as sample, reporting bias, and specific mechanisms between predictors and FOPs that have not yet been explored in depth, further exploration is needed in the future., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Research indicates that fear of progression (FoP) may be a transdiagnostic construct underlying anxiety in people with chronic health conditions. Theories propose that the interpretation of illness-related symptoms (such as pain) might be an important mechanism driving the development of FoP. However, FoP has rarely been studied in diabetes. In this study, we assessed FoP, pain, health threat-related interpretation bias, emotional states, and treatment adherence in 198 participants with type 1 or type 2 diabetes and an age- and gender-matched control group. We hypothesized that 1) people with diabetes will be more likely to interpret ambiguous stimuli as health threat-related than people without diabetes; 2) among those with diabetes, pain severity and interpretation bias will be associated with more severe levels of FoP; and 3) interpretation bias will moderate the relationship between pain severity and FoP in people with diabetes, such that the positive association between pain and FoP will become stronger when people have greater interpretation bias. Our results confirmed that people with diabetes were more likely to interpret ambiguous information as health threat-related compared with people without diabetes, with a large effect (d = .84). Moreover, people with diabetes who reported persistent pain were more likely to interpret ambiguous stimuli as health threat-related (d = .49). Among people with diabetes, pain severity and interpretation bias were significantly associated with FoP. However, we did not find evidence that interpretation bias moderated the relationship between pain and FoP and these relationships could not be accounted for by general psychopathology. PERSPECTIVE: People with diabetes had greater health threat-related interpretation bias than people without diabetes, especially for those with persistent pain and more severe FoP. Both pain severity and interpretation bias were associated with greater FoP, but interpretation bias did not moderate the relationship between pain and FoP., (Copyright © 2024 United States Association for the Study of Pain, Inc. All rights reserved.)

Background: People with multiple sclerosis (pwMS) face disease-related stress throughout their lives, often resulting in depressive mood and fear of progression (FoP). People with a pronounced sense of humor demonstrate greater resilience to stress and tend to perceive threats as challenges. This research investigates whether humor can be identified as a relevant coping factor in pwMS regarding depressive mood and FoP., Methods: Participants were 77 German inpatients aged 25-64 years with predominantly relapsing-remitting MS. Blockwise regression analyses were conducted to examine the relationship between humor skills (Sense of Humor Scale, SHS), depressive mood (Centre for Epidemiologic Studies Depression Scale, CES-D), and fear of progression (Fear of Progression-Questionnaire, FoP-Q), adjusting for demographic, disease-specific, and self-management variables. Correlational and moderator analyses were conducted to evaluate the impact of humor styles (Comic Style Markers, CSM) and self-observation (as a self-distancing measure, Questionnaire to Assess Resources and Self-Management Skills) on these relationships., Results: The summed SHS score was found to be a significant unique determinant for less depressive mood (CES-D, RΔ = 0.05, p = .005), low FoP (FoP-Q sum score, RΔ = 0.06, p = .004), and greater anxiety coping (FoP-Q anxiety coping, RΔ = 0.06, p = .007). Only light humor style was associated with specific FoP-Q scales; the variable dark humor style was not correlated with any study variable. The subscale self-observation failed to moderate between SHS and emotional disorders., Conclusion: Data indicate that humor skills in pwMS are associated with less depression and FoP, which argues for incorporating adaptive humor as a coping resource into psychosocial interventions for pwMS. However, further validation is needed through larger and longitudinal trials., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ann-Kristin Folkerts reports a relationship with Parkinson Foundation, Berlin, Germany that includes: funding grants. Joern Nielsen reports a relationship with PHAROS Foundation, Dortmund, Germany that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Aims: The increasing prevalence of inflammatory bowel disease is emerging as a significant global healthcare concern due to its recurrent episodes of intestinal inflammation. This study aims to explore the relationship between fear of progression and health-related quality of life in inflammatory bowel disease patients, investigating the sequential mediating roles of health literacy and self-care., Design: A cross-sectional study., Methods: Eligible participants diagnosed with inflammatory bowel disease were recruited through convenience sampling method at a tertiary hospital in Shenyang, China, between May 2022 and May 2023. A total of 241 participants completed the questionnaires regarding fear of progression, health literacy, self-care and quality of life. Data analysis was conducted using SPSS 25.0 and PROCESS plug-ins., Results: (1) Fear of progression was found to be negatively associated with quality of life and had a directly predictive effect on quality of life. (2) Health literacy and self-care could independently mediate the relationship between fear of progression and quality of life. (3) There was a significant chain mediating effect of health literacy and self-care in the relationship between fear of progression and quality of life., Conclusion: Fear of progression could not only directly predict the quality of life in inflammatory bowel disease patients but also indirectly affect their quality of life through the chain mediation of health literacy and self-care., Impact: This study highlights the importance of nursing staff focusing on the interplay between fear of progression, health literacy, self-care and quality of life in caring for inflammatory bowel disease patients. Understanding the potential correlation mechanism underlying quality of life may help develop targeted care interventions to synergistically enhance health literacy and self-care in these patients., Reporting Method: STROBE guidelines., Patient or Public Contribution: No public or patient contribution., (© 2024 John Wiley & Sons Ltd.)

Purpose: Studies evaluating oncological inpatient rehabilitation rarely include follow-up intervals beyond 6 months and larger proportions of patients other than those with breast cancer. Therefore, this study investigated changes in health-related quality of life (HRQoL), depression, and fear of progression of patients with breast, colorectal, or prostate cancer from the beginning to the end of oncological rehabilitation and a 9-month follow-up., Methods: Three hundred seventy-seven patients with breast, colorectal, or prostate cancer undergoing oncological inpatient rehabilitation (median age 61 years, 49% female) completed the EORTC QLQ-C30, the PHQ-9, and the FoP-Q-SF at each measurement point. Data analysis used 3 (tumor site) × 3 (time of measurement) repeated measures ANCOVAs with patient age and time since diagnosis as covariates. At each time point, we also compared our sample to the general population on the measures used., Results: Having controlled for the covariates, we found significant effects of tumor site, which were small except for Diarrhea. Effects of time of measurement were often significant and in part at least medium in size indicating improvement of HRQoL and depression during rehabilitation. At follow-up, some HRQoL domains and depression deteriorated. Women with breast cancer, in particular, showed a greater decrease in emotional functioning then. Compared to the general population, the sample's HRQoL and depression were significantly worse on most occasions., Conclusion: Oncological inpatient rehabilitation may improve HRQoL. The subsequent and in part differential deterioration in some HRQoL domains suggests a need for further follow-up care within survivorship programs., (© 2024. The Author(s).)

Background: Adults with advanced cancer experience profound future uncertainty, reflected in elevated fear of cancer progression (FoP) and cancer-related trauma symptoms. These symptoms are associated with physical symptom burden and poorer quality of life, and few interventions exist to manage them. Objective: To develop and pilot a written exposure-based coping intervention (EASE) focused on worst-case scenarios among adults with advanced cancer reporting elevated cancer-related trauma symptoms or FoP. Design: A single-arm intervention development and pilot trial. Participants: The trial enrolled 29 U.S. adults with stage III or stage IV solid tumor cancer ( n  = 24) or incurable or higher-risk blood cancer ( n  = 5) reporting elevated cancer-related trauma symptoms or FoP. Among those screened, 74% were eligible, with an eligible-to-enrolled rate of 85%. Design/Measurements: EASE was delivered over five 1:1 videoconferencing sessions. Feasibility and acceptability were evaluated via attendance, surveys, and exit interviews. Outcomes were assessed at five time points through 3-month (FU1, main assessment of interest) and 4.5-month (FU2) follow-up. Results: Participant and interventionist feedback was used to iteratively refine EASE. Among participants, 86% (25/29) completed all five sessions and FU1; surveys and exit interviews indicated high acceptability. Primary outcomes of cancer-related trauma symptoms and FoP improved significantly from pre to both follow-ups by predominantly large effect sizes. Secondary outcomes of anxiety, depression, hopelessness, fear of death/dying, and fatigue, and most process measures improved significantly by FU1 or FU2. Conclusions: EASE, a novel adaptation of written exposure therapy, is a promising approach to reducing FoP and cancer-related trauma symptoms among adults with advanced cancer that warrants further study.

Purpose: Fear of progression (FoP) leads to poor clinical outcomes in colorectal cancer patients. The study aimed to clarify the profiles and influencing factors of FoP among colorectal cancer patients., Methods: A cross-sectional study was conducted with 409 colorectal cancer patients. Convenience sampling method was used to select colorectal cancer patients hospitalized in a tertiary-level hospital in Nanjing as the survey subjects. General information questionnaire, Fear of Progression Questionnaire-Short Form, Distress Disclosure Index, and Social Support Rating Scale were used to collect the data. Latent profile analysis was used to explore the latent profiles of FoP in colorectal cancer patients. Additionally, the influencing factors of profiles were explored by Univariate Analysis and Binomial Logistic Regression Analysis., Results: Latent profile analysis identified two subgroups of fear of disease progression: the "fear low-risk profile (83%)", and the "severe fear profile (17%)." Patients with low age, low social support utilization, first hospital admission, severe healthcare burden, and preoperative bowel symptoms were prone to severe fear of disease progression., Conclusions: There is some heterogeneity in the level of postoperative fear of disease progression in colorectal cancer patients. Doctors and nurses should focus on patients with severe fear and take targeted preventive and psychological care for patients' fear of disease progression as early as possible according to the distribution characteristics of different categories., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Worry about recurrence or progression is a common concern among people with chronic physical illnesses. Although there are options to measure the fear of cancer recurrence and other illness-specific measures, there is only one transdiagnostic measure of fear of progression, which does not assess the fear of recurrence or relapse., Design: A multi-phase study outlining the development and validation of a novel transdiagnostic measure of fear of recurrence or progression, the Worries About Recurrence and Progression Scale (WARPS)., Method: From a prior systematic review, we used quotes from people with lived experience to generate 55 items. Next, we piloted the items with 10 people with a range of chronic conditions, leading to a final total of 57 items. We then recruited four groups of people with cardiac disease, rheumatic disease, diabetes and respiratory disease (n = 804). An exploratory factor analysis in a randomly split sample resulted in an 18 item, single factor scale. We then performed confirmatory factor analysis on these 18 items in the remaining sample., Results: The 18-item WARPS demonstrated good construct validity, internal consistency and test-retest reliability. Specifically, the WARPS was strongly correlated with the Fear of Progression Questionnaire, and with illness-specific fears. Significant, moderate correlations were observed with depression, anxiety, stress, and death anxiety. The WARPS demonstrated the validity and reliability amongst people with four of the most common chronic conditions and the factor structure was invariant across genders., Conclusion: The WARPS is a valid and reliable tool to measure transdiagnostic worries about recurrence and progression., (© 2023 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Background: Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients., Methods: A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points., Results: The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-value ACT < 0.001; Cohen d ACT  = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group., Conclusions: Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention., (© 2024 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd.)

Objectives: Fear of progression (FoP) among cancer survivors can adversely affect all areas of life. Existing instruments are too long for implementation in routine care. Therefore, we developed and tested a rapid screener for FoP (FoP-Q-RS)., Methods: Data were derived from a register-based study among cancer survivors. The 12-item short form of the Fear-of-Progression Questionnaire (FoP-Q-SF) served as item-pool. Confirmatory factor analysis (CFA) was applied to determine (a) fit indices including comparative fit index (CFI) and standardised root mean square residual (SRMR) and (b) measures of reliability including composite reliability (CR). Fit indices were compared to the FoP-Q-SF. Sensitivity and specificity were calculated to recommend a cut-off (criterion: GAD-7 score ≥10)., Results: One thousand two cancer survivors participated (response rate: 53%). We selected five items for the FoP-Q-RS. CFA indicated acceptable fit (CFI = 0.936; SRMR = 0.048) and reliability (CR = 0.793). Fit indices were better than for the FoP-Q-SF. The cut-off ≥12 showed optimal balance between sensitivity (72%) and specificity (70%), the cut-off ≥10 revealed higher sensitivity (86%) with still tolerable specificity (52%)., Conclusion: The FoP-Q-RS shows good psychometric properties and may be applied in routine care. Further studies on preferable cut-offs and other populations are needed., (© 2021 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.)

Fear of progression (or fear of recurrence) is an appropriate, adequate response to the real threat of cancer. However, elevated levels of fear of progression can become dysfunctional, affecting well-being, quality of life, and social functioning. Research has shown that fear of progression is one of the most frequent distress symptoms of patients with cancer. As a clear consensus concerning clinically relevant states of fear of progression is still lacking, it is difficult to provide a valid estimate of the rate of cancer patients who clearly suffer from fear of progression. Current evidence suggests that probably 50% of cancer survivors experience moderate to severe fear of progression. Furthermore, many patients express unmet needs in dealing with the fear of cancer spreading. These results underscore the need to provide effective psychological treatments for clinical states of fear of progression. Some psychosocial interventions for treating fear of progression have been developed. Our own, targeted intervention study showed that clinical fear of progression can be effectively treated with brief group therapy.

Objective: The relation between fear of progression (FoP) and anxiety disorders remains unclear. Therefore, we investigated the comorbidity between clinical FoP and psychiatric anxiety disorders., Method: In this cross-sectional study, 341 cancer patients undergoing acute inpatient care participated. A structured clinical interview (Structured Clinical Interview for DSM-IV Axis I) was used to identify Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition anxiety disorders and hypochondriasis. Patients completed measures of FoP (Fear of Progression Questionnaire), worries (Penn State Worry Questionnaire, Worry Domains Questionnaire), depression [Patient Health Questionnaire (PHQ): Depression], anxiety (PHQ: General Anxiety Disorder) and somatic symptoms (PHQ: Somatic Symptoms). We cross-tabulated FoP with the presence of anxiety disorders and studied associated variables., Results: Of all patients studied, 17.6% suffered from an anxiety disorder. With regard to comorbidity, 68.3% suffered neither from clinical FoP nor from any anxiety disorder, 13.4% had not been diagnosed with an anxiety disorder but experienced clinical FoP, and 11.6% only suffered from an anxiety disorder. The remaining 6.7% suffered from FoP that was comorbid with an anxiety disorder. Patients with a pure FoP did not differ from patients with a pure anxiety disorder on nearly all symptom measures. Only a few associations between the comorbidity pattern and sociodemographic and clinical variables emerged., Conclusion: Clinical FoP appears to be a distinct phenomenon. It does not differ from anxiety disorders in its psychological and somatic burdens., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Existing research indicates that fear of progression influences the quality of life of patients with various diseases. However, the influence of fear of progression on the quality of life of patients with heart failure and its underlying mechanisms remain unclear. This study aimed to identify the link between fear of progression and quality of life in patients with heart failure and explore the multiple mediating roles of psychological distress and resilience in this association. Methods: This multicenter, cross-sectional study was conducted between March and December 2023 across four tertiary hospitals in China. Data on fear of progression, psychological distress (anxiety and depression), resilience, and quality of life were collected. The PROCESS macro in SPSS was used to analyze the multiple mediation model. Results: The study involved 277 patients. The total indirect effect of fear of progression on quality of life was significant. Fear of progression influenced physical quality of life through two pathways: (i) resilience independently, and (ii) psychological distress-depression and resilience serially. Additionally, fear of progression influenced mental quality of life through three pathways: (i) psychological distress (anxiety and depression) independently, (ii) resilience independently, and (iii) psychological distress (anxiety and depression) and resilience serially. However, psychological distress-anxiety or resilience had no mediating effect on the relationship between fear of progression and physical quality of life in patients with heart failure. Conclusions: Fear of progression had a negative association with quality of life in patients with heart failure. In addition, the relationship between fear of progression and quality of life was mediated by psychological distress and resilience. Interventions targeting the reduction of psychological distress and enhancement of resilience may mitigate the impact of fear of progression on quality of life in patients with heart failure. [ABSTRACT FROM AUTHOR]

Background: Acute myocardial infarction (AMI) is the most serious manifestation of coronary artery disease. At present, existing treatments cannot change the risk factors for the occurrence of the disease, so patients are prone to fear of progression or recurrence, and studies have shown that excessive fear will cause patients to over-examine, mental abnormalities, suicide and other behaviors, increase unnecessary medical care costs and the social medical burden. Thus to investigate the current situation of progression fear in patients with Acute Myocardial Infarction (AMI) admitted to hospital in stable stage and analyze its influencing factors. Methods: This is a cross-sectional study. In this study, 160 AMI patients admitted to the Department of Cardiology of a 3 A hospital in Changchun from November 2022 to April 2023 were selected as the research sample by a convenient sampling method. Patients completed the general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Medical Coping Modes Questionnaire (MCSQ), the Social Support Rating Scale (SSRS), and the Positive Psychological Questionnaire (PPQ) at the time of stable condition. Using SPSS 25.0 software for data analysis, statistical methods mainly include descriptive statistics, analysis of variance, Pearson correlation analysis and multiple linear regression analysis. Results: A total of 160 subjects were included, among which the score of simplified fear of progression scale was (33.43 ± 7.09), and the incidence of disorder of fear of progression was 50.60%. The influencing factors included gender (Beta = 0.118, P<0.05), disease perception (Beta = 0.445, P<0.001), psychological capital (Beta=-0.252, P<0.05) and resignation (Beta = 0.167, P < 0.05). Conclusion: The overall level of fear of progression in patients with AMI at the stable stage of hospitalization is above the medium level. Nursing staff should focus on AIM patients suffering from multiple diseases and lacking awareness of their own diseases, and provide personalized health guidance and psychological nursing targeted to improve patients' rehabilitation, quality of life and FoP level. [ABSTRACT FROM AUTHOR]

Background: The relationship between recurrence risk perception, fear of progression, and health behaviors in patients with ischemic stroke is unclear. Objective: To explore the effect of accuracy and level of recurrence risk perception on health behaviors and the mediating role of fear of progression. Methods: We conducted a 2-wave survey. Patients with ischemic stroke (N = 261) were recruited from 2 hospitals in Guangzhou, China. Before discharge, demographic information, objective recurrence risk, perceived recurrence risk, fear of progression, and health behaviors were investigated. After 1 month, the patient's health behaviors were followed up. Results: The median (quartiles 1-3) scores for recurrence risk perception and fear of progression were 43.0 (39.0-46.0) and 22.0 (18.0-28.0), respectively. Only 22.2% of the patients correctly perceived the risk of recurrence, 23.0% underestimated the risk, and 30.7% overestimated the risk. Patients who overestimated the risk of recurrence (β = 0.421, P =.002) or had a higher perceived level of recurrence risk (β = 0.446, P <.001) had a higher fear of progression, which contributed to better health behaviors at 1 month (β = 0.197, P =.001). Fear of progression played a partial and full mediating role, respectively. Patients who underestimated the recurrence risk had worse health behaviors than those who accurately perceived it (β = −0.296, P =.033). Conclusion: Both accuracy and level of recurrence risk perception were independent predictors of future health behaviors, and fear of progression was mediating. Health care professionals should develop individualized risk education programs to help stroke patients properly understand and cope with the risk of recurrence. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the mediating role of perceived social support and illness uncertainty in posttraumatic growth (PTG) and fear of progression (FoP) among young and middle-aged primary brain tumor (PBT) patients. A total of 252 young and middle-aged benign PBT patients were investigated. Data were collected by using self-designed general and disease-related data questionnaires, PTG Inventory, FoP Questinaire-Short Form, Mischel Uncertainty in Illness Scale, and Perceived Social Support Scale. Parallel mediation effect models were used to explore the relationship between PTG and FoP mediation effects. Bootstrap analysis was conducted to examine the mediation effect of PTG on FoP. The total FoP and PTG scores were 35.15 ± 4.85 and 55.04 ± 7.86. Furthermore, mediation effect analyses revealed that perceived social support and illness uncertainty were partially associated with the mediated relationship between PTG and FoP. (std.β = −0.026, P -value = 0.001, std. β = −0.393, P value ＜0.001, respectively). Illness uncertainty and perceived social support were identified as partially parallel mediators between PTG and FoP. Thus, we should ensure adequate social support and improve the enthusiasm and input of family members for better patient recovery. Strengthening the nursing support, reducing the uncertainty of young and middle-aged PBT patients, and improving the patients' PTG can help reduce the fear of disease progression. [ABSTRACT FROM AUTHOR]

As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers. [ABSTRACT FROM AUTHOR]

Simple Summary: Anxiety, depression and fear of cancer progression are common psychological challenges faced by women with ovarian cancer. It can affect a person's well-being, treatment compliance and quality of life. In this study, we assessed how often and how severe these concerns are 12 months after surgical treatment and if there is any association with surgical, patient and tumour factors. A total of 141 patients with advanced ovarian cancer who did not have disease progression at 12 months post-surgery completed two questionnaires. We found that a significant proportion of patients undergoing surgery for ovarian cancer experience anxiety, depression and fear of progression. It was not possible to identify a group of patients who are more affected by anxiety, depression or fear of progression. It is essential for healthcare providers to be attentive to the emotional needs of all ovarian cancer patients and provide appropriate support to help them cope with these psychological concerns effectively. Patients with ovarian cancer (OC) often experience anxiety, depression and fear of progression (FOP); however, it is unclear whether surgical complexity has a role to play. We investigated the prevalence of anxiety, depression and FOP at 12 months post-cytoreductive surgery and investigated associations with surgical complexity, patient (age, ethnicity, performance status, BMI) and tumour (stage, disease load) factors. One hundred and forty-one patients with FIGO Stage III–IV OC, who did not have disease progression at 12 months post-surgery, completed the Hospital Anxiety and Depression Scale and FOP short-form questionnaire. Patients underwent surgery with low (40.4%), intermediate (31.2%) and high (28.4%) surgical complexity scores. At 12 months post-surgery, 99 of 141 (70%) patients with advanced OC undergoing surgery experienced clinically significant anxiety, 21 of 141 (14.9%) patients experienced moderate to severe depression and 37 of 140 (26.4%) experienced dysfunctional FOP. No associations were identified between the three different surgical complexity groups with regards to anxiety, depression or FOP scores. Unsurprisingly, given the natural history of the disease, most patients with OC suffer from anxiety, depression and fear of progression after completion of first-line cancer treatment. Surgical complexity at the time of surgery is not associated with a deleterious impact on anxiety, depression or FOP for patients with OC. Patients with OC experience a profound mental health impact and should be offered mental health support throughout their cancer journey. [ABSTRACT FROM AUTHOR]

Background: An emerging area of psycho-cardiology explores fear of disease progression in cardiac patients, following extensive research of this topic in psycho-oncology. Novel interventions that target cardiac fear of progression(FoP) may be valuable in bridging the gap between the high psychological support needs in cardiac care and limitations surrounding the efficacy of standard psychosocial treatments. However, there appears to be limited research characterizing FoP in cardiac patients with which to inform potential interventions. Aims: Using a mixed methods approach in two inter-related studies, we aimed to develop a preliminary conceptualization of cardiac-FoP. Methods: Study 1 involved a scoping review of existing qualitative research to identify the range of fears relating to disease progression reported by cardiac patients. Study 2 investigated the prevalence and distress levels associated with a selection of fears identified in Study 1 through a quantitative study of 194 cardiac patient admissions at two Australian hospitals. Results: Study 1 conceptualized cardiac-FoP in two ways, by the content of the fears and by the behavioral responses to the fears. Fears were categorized into seven broad domains: fears associated with death, health, interpersonal relationships, treatment, accessing help, role responsibilities, and physical activity. Five categories of behavioral responses were identified: avoidance, hyperawareness, symptom misattribution, seeking help, and lifestyle changes. Study 2 indicated a high prevalence of fear, with an average endorsement of 40.9%. When fear was endorsed, an average of 45.2% of cardiac patients experienced moderate-to-severe distress. Discussion: This paper provides an initial conceptualization of FoP in cardiac patients, providing preliminary evidence of the rates of fear and associated distress in this population. Drawing on this conceptualization, unique measurement tools and interventions should be developed to identify and address FoP in cardiac patients. [ABSTRACT FROM AUTHOR]

Death anxiety is understudied in people with cancer, especially in relation to fear of cancer recurrence (FCR) and fear of progression (FOP). The present study aimed to identify if death anxiety can predict FCR and FOP over and above other known theoretical predictors. One hundred and seventy-six participants with ovarian cancer were recruited for an online survey. We included theoretical variables, such as metacognitions, intrusive thoughts about cancer, perceived risk of recurrence or progression, and threat appraisal, in regression analyses to predict FCR or FOP. We investigated whether death anxiety added to the variance over and above these variables. Correlational analyses demonstrated that death anxiety is more strongly associated with FOP than FCR. The hierarchical regression including the theoretical variables described above predicted 62–66% of variance in FCR and FOP. In both models, death anxiety predicted a small but statistically significant unique variance in FCR and FOP. These findings draw attention to the importance of death anxiety in understanding FCR and FOP in people with a diagnosis of ovarian cancer. They also suggest that elements of exposure and existentialist therapies may be relevant in treating FCR and FOP. [ABSTRACT FROM AUTHOR]

Aims: Fear of progression of cancer patients can affect their psychological well‐being, while research on fear of progression of advanced lung cancer patients is limited. This study aimed to describe fear of progression among advanced lung cancer patients and explore the relationships among symptom experience, family support, health literacy, and fear of progression. Design: This study was a cross‐sectional study. Methods: Convenience sampling was used to select advanced lung cancer patients from September 2021 to January 2022. The Chinese version of the Fear of Progression Questionnaire‐Short Form, Lung Cancer Module of the MD Anderson Symptom Inventory, Family Support Questionnaire, and Health Literacy Scale for Patients with Chronic Disease were used to collect data. The structural equation modelling was used to analyse the relationships among symptom experience, family support, health literacy, and fear of progression. Results: Of 220 patients, 31.8% had dysfunctional fear of progression. Better symptom experience, higher family support, and higher health literacy were correlated directly with lower fear of progression. Higher health literacy was associated indirectly with lower fear of progression through the mediation of better symptom experience. Conclusion: Fear of progression among advanced lung cancer patients needs attention. Strengthening symptom management, building a strong system of family support, and improving patients' health literacy may be effective strategies to reduce fear of progression. Impact: The research aimed to increase our understanding of the relationships among symptom experience, family support, health literacy, and fear of progression. Fear of progression screening should be integrated into the healthcare trajectory of advanced lung cancer patients. The results emphasize that improving symptom management, family support, and health literacy is important to alleviate fear of progression. Further interventions are warranted to relieve fear of progression for advanced lung cancer patients. Patient or public contribution: No public or patient involvement. [ABSTRACT FROM AUTHOR]

Aims Studies have shown that symptom perception is associated with fear of progression (FOP) in many diseases and regulated by psychological factors. Whether the association also occurs in patients with chronic heart failure (HF) remains unclear, as do the specific mechanisms involved. This study aimed to explore the multiple mediation effects of self-care confidence and mental resilience on the relationship between symptom perception and FOP in Chinese patients with chronic HF. Methods and results A cross-sectional study was conducted on 247 patients with chronic HF recruited from two hospitals in Yangzhou, China. The sociodemographic and clinical data and self-reported questionnaires including heart failure somatic perception, fear of progression, self-care confidence, and mental resilience were collected. Data analysis relating to correlations and mediating effects was carried out by SPSS 26.0 and PROCESS v3.3 macro. Fear of progression was positively correlated with symptom perception (r = 0.599, P < 0.01), but negatively correlated with self-care confidence (r = −0.663, P < 0.01), mental resilience-strength (r = −0.521, P < 0.01), and mental resilience-toughness (r = −0.596, P < 0.01). The relationship between symptom perception and FOP was mediated by self-care confidence [effect = 0.095, 95% confidence interval (CI) (0.054–0.142)] and mental resilience-toughness [effect = 0.033, 95% CI (0.006–0.074)], respectively, and together in serial [effect = 0.028, 95% CI (0.011–0.050)]. The proportion of the mediating effect accounting for the total effect was 31.0%. Conclusion Self-care confidence and mental resilience-toughness were multiple mediators of the association between symptom perception and FOP in patients with chronic HF. Interventions targeted at strengthening self-care confidence and mental resilience may be beneficial for the reduction of FOP, especially with regard to toughness. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to measure sleep quality and its possible association with fear of progression (FOP) in patients with chronic heart failure (HF). Design: A cross‐sectional study. Methods: A total of 254 patients with chronic HF were recruited from two tertiary hospitals in China. The sociodemographic and clinical data of participants were collected using a general information questionnaire. The Pittsburgh Sleep Quality Index and Fear of Progression Questionnaire‐Short Form were used to evaluate sleep quality over 1 month and FOP. Pearson correlation and hierarchical regression were conducted to analyse the relationship between sleep quality and FOP. Results: Of all participants, 85.8% had poor sleep quality, with a mean score of 12.3 ± 4.2 (possible score could be 0 to 21). The severity of FOP was positively correlated with poor sleep quality. HF hospitalization in the past year, numbers of HF drugs, monthly income and total score of FOP were strong predictors of decreased sleep quality, accounting for 24.2% of the variance in the sleep quality of these patients. Conclusions: Patients with chronic HF generally reported poor sleep quality, which should be highly concerned for medical workers. Alleviating FOP as a therapeutic strategy may improve sleep quality. Impact: It is urgent to raise clinical attention that Chinese patients with chronic HF have poor sleep quality, which is not just due to the symptoms of HF itself. FOP is an important psychological factor influencing sleep quality in patients with chronic HF, which has not been explored in China. This study provides a new perspective on targeted interventions for poor sleep quality in chronic HF. Patient and public involvement: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has rarely been studied outside of the cancer context. This review aimed to: (1) meta-synthesise qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e., seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses. [ABSTRACT FROM AUTHOR]

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Background: Fear of progression (FoP) is a reactive, conscious concern about chronic disease progression and its consequences which may limit quality of life substantially. Only one study has examined FoP in Parkinson's disease (PD), showing the second highest FoP scores among chronic diseases. Objective: To examine FoP prevalence and to exploratorily analyze determinants of FoP in PD. Methods: Within a multicenter cross-sectional study, 120 PD inpatients (age: 64.45±9.20; 60.8% male; UPDRS-III: 28.86±16.12) were examined with the FoP questionnaire (FoP-Q; max. 20 points). Stepwise multiple linear regression analysis examined sociodemographic, clinical, and (neuro-) psychological determinants of FoP. Results: With a mean FoP-Q score of 8.08±2.17, 63.0% of the patients were classified with moderate FoP and 17.6% with dysfunctional (i.e., severe) FoP. The highest scores were shown for the subscale 'loss of autonomy'. Increased levels of anxiety, less self-efficacy, female gender, current employment, and lower health literacy were identified as significant determinants associated with FoP. Conclusion: With more than 80% of patients showing moderate to dysfunctional FoP, it must be regarded as a frequent symptom in PD, which needs to be further understood and addressed in clinical practice. Clinical parameters like PD duration and severity were no determinants for FoP, indicating that FoP awareness must be considered by professionals at all disease stages. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19. Background: At the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored. Methods: During February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors. Results: The fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression. Conclusion: With a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning. Summary statement: What is already known about this topic? Fear of progression is a common bio‐socio‐psychological consequence that widespread in cancer patients as well as chronic diseases.Very few studies focus on fear of progression in patients with major infectious disease, not to mention coronavirus disease (COVID‐19). What this paper adds? The present study surveys fear of progression in patients with mild or common type COVID‐19 and revealed a low‐to‐moderate level overall.Being unemployed, having no spouse diagnosed with COVID‐19, and a disease duration of 28 days or more are potential factors associated to patients' fear of the disease progression. The implications of this paper: The COVID‐19 outbreak has been declared as a public health emergency of international concern. Mental health problems such as fear of disease progression might need more attention beyond medical treatment.Future mental health nursing practice and research need to focus on those potential factors or patients with specific characteristics. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to investigate whether fear of progression mediates the association between illness perception and quality of life among interstitial lung disease patients. Background: So far, the physiological treatment of interstitial lung disease is limited. In addition to immunosuppressants such as glucocorticoids, two anti‐fibrosis drugs (pirfenidone and nintedanib) have shown moderately beneficial effects on slowing the progression of interstitial lung disease fibrosis. However, none of these drugs has shown reliable or strong beneficial effects on improving quality of life. Psychological care and mental health support strategies focusing on improving patients' quality of life are particularly important. Design: A cross‐sectional study. Methods: A convenience sample of patients suffering from interstitial lung disease were enrolled from August to December 2019. Data including sociodemographic and clinical characteristics, illness perception, fear of progression and quality of life were collected. The descriptive analysis and Pearson correlations were analysed by SPSS 26.0 (IBM Corp.). PROCESS v3.4 (by Andrew F. Hayes) macro was applied to analyse the mediating effects. We used the STROBE checklist to report the results. Results: Both illness perception and fear of progression were correlated with quality of life. Fear of progression mediated the association between illness perception and quality of life. The indirect effect was 0.121, and the proportion of intermediary effect in the main effect was 26.36%. Conclusion: Interstitial lung disease patients experience relatively poor quality of life and fear of progression exerts a mediating role between illness perception and quality of life. Relevance to clinical practice: This study alerts medical staff to pay attention to negative illness perception and excessive fear, which is helpful to formulate effective interventions to manage interstitial lung disease patients' quality of life. [ABSTRACT FROM AUTHOR]

This studyinvestigates the need for psycho-oncological care over the course of a breast cancer treatment and possible associated factors to develop such a need. The PIAT-Study was a longitudinal postal survey study conducted in Germany (2013 to 2014) with breast cancer patients (BCPs). Patients received a questionnaire at three-time points (T1: few days after surgery, T2: after 10 weeks; T3: after 40 weeks). This study considers information about patients' needs for psycho-oncological care, their breast cancer disease, social support, anxiety, health literacy (HL) and sociodemographic information. Data were analysed with descriptive statistics and logistic regression modelling to estimate the association between a need for psycho-oncological treatment and patient characteristics. N = 927 breast cancer patients reported their psycho-oncological need. 35.2% of patients report at least at one measuring point to be in need for psycho-oncological care. In a multiple logistic regression, noticeable determinants for developing such a need are an inadequateHL(OR = 1.97), fear of progression (FoP) (OR = 2.08) and psychological comorbidities (OR = 8.15) as well as certain age groups. BCPs with a low HL, suffering from a dysfunctional level of FoP or mental disorders are more likely to develop a need for psycho-oncological care. [ABSTRACT FROM AUTHOR]

This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self‐report on FoP (Fear of Progression Questionnaire—parent version, FoP‐Q‐SF/PR), individual coping (Coping Health Inventory for Parents, CHIP‐D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor‐partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP‐D FAM) and maintaining social support (CHIP‐D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple‐based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP. [ABSTRACT FROM AUTHOR]

Purpose: Our research aimed to identify whether specific aspects of health literacy (HL) are associated with quality of life (QOL) and fear of progression (FOP) in men with prostate cancer (PC).Methods: We conducted a cross-sectional study. Regarding HL, we surveyed communication skills, guideline awareness, and knowledge in several domains: PC, health care system, own physical condition, dealing with health problems. Research questions were addressed using regression models for QOL and FOP including sociodemographic and disease-related variables as additional predictors.Results: One thousand five hundred seventy-seven men completed the questionnaire. Better QOL was statistically significant associated with communication skills (OR 2.24; CI 1.57-3.21), knowledge of dealing with health problems (OR 2.54; CI 1.74-3.72), and knowledge of own physical condition (OR 0.63; CI 0.42-0.95). FOP decreased with increasing communication skills (β - 0.09; CI - 0.15 to - 0.04), knowledge of health care system (β - 0.07; CI - 0.12 to - 0.02), and knowledge of dealing with health problems (β - 0.21; CI - 0.27 to - 0.15). It increased with guideline awareness (β 0.07; CI 0.02-0.11), PC knowledge (β 0.11; CI 0.06-0.16), and knowledge about own physical condition (β 0.11; CI 0.05-0.17).Conclusions: The findings lead to the hypothesis that some aspects of HL may have a positive and some a negative influence on men with PC. Men should not be overwhelmed by a recommendation for self-observation or by promotion of PC knowledge. Interventions are needed that provide knowledge for managing health problems. Communication in health care should be tailored to men's needs. [ABSTRACT FROM AUTHOR]

People with rheumatoid arthritis (RA) have higher levels of fear of disease progression (FOP) than cancer survivors. In cancer, FOP is inextricably linked with existential concerns. However, this has not been investigated in people with RA. We recruited 165 people with RA (96%F) who volunteered for a treatment trial of psychological intervention. Participants completed the Existential Concerns Questionnaire (ECQ) and questionnaires measuring constructs associated with FOP in cancer. We created groups of people with RA, with and without clinically significant levels of FOP (clinical and control groups) and compared their existential concerns. We hypothesized that existential concerns would add to the variance in FOP over and above pain, psychopathology, and disability. Nearly two-thirds of people with RA scored in the clinical range for FOP. The clinical group had higher levels of all existential concerns than the control group. When subscales of the ECQ were entered into a multiple regression with FOP as the dependent variable, death anxiety, meaninglessness and guilt domains accounted for significant variance in FOP. Moreover, when added to a regression equation controlling all other variables, existential concerns continued to account for unique variance in FOP (t = 2.712, p = 0.007). Existential concerns were strongly associated with FOP. While this cross-sectional study cannot determine whether existential concerns underlie FOP in RA, these results show robust relationships that warrant future investigation. • Fears of illness progression were prevalent in those with rheumatoid arthritis. • Existential concerns were strongly associated with fears of progression. • Existential concerns contributed unique variance over and above other predictors. [ABSTRACT FROM AUTHOR]

Background: Since biological valve recipients are likely to need a redo procedure in the future for valve deterioration, we hypothesized patients might be more fearful about the progression of their disease than patients after aortic valve replacement (AVR) with a mechanical valve. The aim of this study is to compare the quality of life (QOL) and anxiety in patients who have undergone biological versus mechanical AVR. Methods: A total of 56 patients after mechanical AVR (mean age: 64.4 ± 8.17 years) and 66 patients after biological AVR (mean age: 64.8 ± 11.05 years) received three questionnaires 5.66 (±2.68) years after surgery, including: The short form-36 (SF-36) to assess QOL, the fear of progression questionnaire (FOP), and the cardiac anxiety questionnaire (CAQ) to assess general anxiety, anxiety related to cardiac symptoms, and anxiety about progression of heart disease and valve and anticoagulation-specific questions. Results: No significant differences were found for all categories of the SF-36. The FOP showed significantly favorable values for the biological AVR group. The CAQ showed a tendency in the subscale "avoidance" (i.e., avoidance of pulse increase) and "attention" towards more favorable values for the biological AVR group. Conclusions: In contrast to our hypothesis, patients after mechanical AVR show significantly higher anxiety values for the FOP, and a tendency toward higher values for "avoidance" (i.e., avoidance of pulse increase). Partnership concerns, especially in terms of sexuality can be explained by factors that are recognizable for the partner, such as valve sound. These data provide evidence that factors that are continuously present after mechanical AVR, such as valve sound or anticoagulation might affect wellbeing stronger than the certainty of reoperation in the future after biological AVR. We conclude that implantation of a biological prosthesis can be justified in younger patients with regards to QOL. [ABSTRACT FROM AUTHOR]

Background Parents caring for a child with a chronic somatic condition are at risk of increased distress and impaired quality of life. Fear of disease progression (FoP) is known to be an important source of distress in patients and their partners, and may be of relevance for parents as well. Existing measures are not applicable to parents. This study describes the adaptation of the FoP questionnaire for parental caregivers and investigated its psychometric properties. Methods Sixteen items appropriate for parents were derived from existing measures and from interviews with clinical experts in family-oriented psychosocial care. Factor structure, internal consistency, validity and sensitivity to change were analyzed in a clinical sample of 162 caregivers ( M age = 42.07 years, SD = 6.0 years, 87.8% female) of a child with cystic fibrosis. Results The exploratory factor analysis revealed a two-factor structure, which was not supported by confirmatory analysis. Cronbach ' s α was examined for total score (.91) and significant positive correlations of the total score with anxiety (HADS: r = .70) and depression (CES-D: r =.60, BDI-II: r =.59), and a significant negative correlations with quality of life ( r = − .66) could be demonstrated. A significant decrease in FoP was found ( d = 1.11) in a group of highly distressed caregivers undergoing web-based cognitive behavioral intervention. Conclusions The FoP questionnaire is a reliable and valid instrument for parents of children with CF. Further studies in larger samples are needed to clarify dimensionality and validity among parents of children with other chronic conditions. [ABSTRACT FROM AUTHOR]

People living with chronic illness often report uncertainty about the future, fear of disease progression, fear of becoming physically disabled, and a reduced life expectancy as important sources of stress. However, little is known about psychological interventions targeting these concerns. The aim of this study is to illustrate an intervention to reduce emotional distress and concerns about the future in a patient with systemic sclerosis (SSc), a rare chronic rheumatic disease with serious consequences for most patients, and to present a preliminary report on its effectiveness using a single-case study design. Because of the complexity of symptoms and complaints due to SSc, the psychological intervention was embedded in an interdisciplinary care program also consisting of physical therapy, occupational therapy, and specialized nurse care. [ABSTRACT FROM AUTHOR]

Prior work demonstrated that cognitive–behavioral (CBT) and supportive–experiential (SET) group interventions can reduce dysfunctional fear of progression (FoP) in patients with chronic diseases. In this secondary analysis of a randomized controlled study, we investigated determinants of long-term response to group therapy for FoP. Response to therapy after 12 months was assessed using the Reliable Change Index (RCI). Outcome data were available for 129 patients with cancer and 116 patients with chronic arthritis. 37.9% of the patients in the CBT group and 32.7% of those attending the SET group indicated response to therapy (p = .402). Educational level predicted long-term response to therapy (OR 2.53, 95% CI 1.33–4.81; p = .005). Medical patients with lower education may need additional attention in order to gain long-lasting benefit from brief group psychotherapy. However, this investigation needs to be replicated in a study that includes a broader range of psychological predictors. [ABSTRACT FROM PUBLISHER]

Fear of progression (FoP) is one of the most prevalent symptoms in cancer patients. This chronic disease does not only have a profound impact on patients, but also on their spouses. The aim of this study was to evaluate the psychometric properties of a spouse FoP questionnaire (FoP-Q-SF/P) in 227 partners of chronically ill patients (breast cancer, prostate cancer, and diabetes mellitus) in Germany. Estimates of reliability were high (α = 0.88). The original one-factor structure of the FoP-Q-SF for patients was replicated. We used the Hamilton Anxiety and Depression Scale, Impact of Event Scale-revised, Short Form–8 Health Survey, Quality of Marriage Index, Partnership Questionnaire, and Dyadic Coping Inventory to validate the FoP-Q-SF/P. Significant positive correlations were found for anxiety, hyperarousal and intrusion (r > .61) as well as for depression and avoidance (r > .51). Partners of patients with cancer reported significantly higher levels of FoP than did partners of patients with diabetes mellitus. The FoP-Q-SF/P is a reliable and valid instrument that can be recommended for further use in research and clinical care. [ABSTRACT FROM PUBLISHER]

Purpose 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. Methods 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. Results Analyses showed a significant main effect for time and a significant interaction for group × 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. Conclusions Fear of progression, one of the main sources of distress for cancer patients, can be reduced with short psychotherapeutic interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study investigated the fear of progression (FoP) in cancer patients and the discriminant ability of the Fear of Progression Questionnaire (FoP-Q) against the Hospital Anxiety and Depression Scale (HADS), while also examining relationships between FoP, satisfaction outcomes and supportive needs. Method: The FoP-Q and HADS were administered to 112 cancer patients in Korea during June and July 2006. The FoP-Q totals and subscales, and the HADS scores were compared across three groups (patients with recurrence, patients with metastases and controls experiencing neither). Results: Comparison of the FoP-Q total score to HADS anxiety (HADS-A) and depression (HADS-D) scores showed higher FoP in the recurrence group compared to the control group (P=.009). Subscale score comparisons revealed a heightened “affective reaction” (P=.003) to cancer progression and fear of “loss of autonomy” (P=.011) in recurrence patients. FoP-Q score showed a moderate association with HADS-A (r=.54, P=.000) and a significant association with treatment satisfaction (r=−.26, P=.007), medical staff and communication (r=−.31, P=.001), and supportive needs (r=.41, P=.000). Conclusion: The importance of providing supportive interventions tailored to the specific emotional concerns of cancer patients, assessed via appropriate, disease-specific instruments, and the need to pay special attention to the concerns of recurrence patients are suggested. [Copyright &y& Elsevier]