| Summary: | 博士 === 國立臺灣大學 === 護理學研究所 === 104 === Research background and aims: Head and neck cancer (HNC) is one of the top five fatal diseases among men in Taiwan. Fear of cancer recurrence (FCR) is identified as the most concern and psychological distress for patients and their family caregivers (FCs). The purposes of the study were: (1) to examine psychometric properties of the Chinese version of Fear of Cancer Recurrence Inventory-Caregiver version (FCRI-c); (2) to identify current status and factors associated with fear of cancer recurrence in family caregivers of patients with HNC. Research Design: A cross-sectional study with purposive sampling was conducted. Patient-family caregiver dyads were recruited from the outpatient radiation department of a medical center in northern Taiwan. A total of 215 patient-family caregiver dyads were recruited in this study. Statistical analysis: In the first part, confirmatory factor analysis (CFA) and Pearson correlation were used to analyze the reliability and validity. In second part, the data analysis was conducted with t-test, Pearson correlation, ANOVA, and hierarical multiple regression. Results: (1) The FCRI-c had acceptable internal consistency and test-retest. The FCRI-c had construct validity, supported by seven factors. The FCRI-c had concurrent validity, supported by the FCs’ anxiety and depression. The FCRI-c had divergent validity, supported by the FCs’ physical quality of life; (2) The trigger of FCR is the most concerned part in caregivers, in particular, while patients had some physical distress or got sick. FCs’ FCR is also reflected in the severity of worry about metastasis and recurrence. FC cope with FCR by accompanying with patient going to the hospital or clinic for examinations and convincing themselves positively; (3) The factors significantly correlated with the FCRI-c or its seven subscales were: patient’ age, chronic disease, income, cancer recurrence or metastasis before, and time since completion of treatment; FCs’ education, income, and religion. Negative associations were found between FCs’ fear of recurrence, patients’ cancer-related pain, fatigue, and related distress; a significant negative association was also found between FCs’ fear of recurrence, patients’ physical wellbeing, and head & neck concern. Positive associations were found between FCs’ fear of recurrence and FCs’ social inhibition and negative affective of D-type personality; a significant negative association was also found between FCs’ fear of recurrence and FCs’ tangible, emotional/information, and overall social support; and (4) Factors significantly related to FCs’ triggers of FCR were patients’ average fatigue, and FCs’ negative affect of D-type personality trait; Factors significantly related to FCs’ severity of FCR were patients’ cancer recurrence or metastasis before, patients’ average fatigue, and FCs’ negative affective of D-type personality trait. Conclusion and clinical practice: The FCRI-c is a valid instrument to provide healthcare providers to assess FCs’ fear of cancer recurrence. Future research should use Longutidinal follow up and and additional
interventions related to effective coping resources are needed.
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