Highlights
- •The situation resulting from cancer disrupts the balance in family dynamics.
- •Cohesion, disengagement, enmeshment, and satisfaction do not impact FCR severity.
- •Balanced family flexibility and higher communication level decrease FCR severity.
- •While rigid family functioning does not impact FCR, chaotic functioning increases it.
Abstract
Objective
To explore the links between family functioning—in terms of cohesion, flexibility,
and communication—and the fear of cancer recurrence (FCR) in a sample of breast cancer
survivors of Lebanese women.
Methods
This was a cross-sectional study among 62 Lebanese adult women (mean age: 51.0 ± 8.29
years; years since diagnosis: 7.19 ± 7.06) in remission, included via convenience
and snowball sampling. A multicomponent questionnaire, encompassing socio-demographic
and medical questions, the “Family Adaptability and Cohesion Evaluation Scale,” the
“Family communication scale,” and the “Family satisfaction scale” (FACES IV) and the
short version of the “Fear of Cancer Recurrence Inventory” (FCRI–SF), was used. Descriptive,
bivariate, and multivariate analyses were conducted. A p-value<0.01 was used to indicate
statistical significance.
Results
On average, FCR was clinically non-significant (12.31 ± 7.76). The sample had a low
disengagement (20.01 ± 4.83), very low enmeshment (19.68 ± 4.57), very low rigid operation
(21.7 ± 4.26), very low chaotic functioning (16.43 ± 4.48), high family communication
level (38.78 ± 7.96), connected balanced cohesion (28.18 ± 5.47), very flexible balanced
flexibility (26.81 ± 4.56), and low level of family satisfaction (34.53 ± 8.04). A
very low chaotic functioning in the family (B = −11.37, Beta = −0.49, 99%CI = −19.54,
−3.19), very high and low communication (B = −6.04, Beta = −0.33, 99%CI = −11.42,
−0.67; B = −11.85, Beta = −0.46, 99%CI = −20.13, −3.58, respectively), very flexible
balanced flexibility (B = −10.36, Beta = −0.67, 99%CI = −15.77, −4.94) and younger
age (B = −0.31, Beta = −0.37, 99%CI = −0.59, −0.04) predicted a lower FCR score.
Conclusion
Balanced flexibility and the quality of communication within the family were associated
with a decreased FCR, while chaotic family functioning increased FCR severity. Cohesion,
disengagement, enmeshment, and family satisfaction did not impact the severity of
FCR.
Keywords
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References
- Les Thérapies Familiales Systémiques.Elsevier Health Sciences, 2014
- The limitations of online surveys.Indian J. Psychol. Med. 2020; 42: 575-576
- La force du lien face au cancer.Odile Jacob, 2009
- Adult cancer survivors: how are they faring?.Cancer. 2005; 104: 2565-2576
- Comparison of stopping rules in forward “stepwise” regression.J. Am. Stat. Assoc. 1977; 72: 46-53
- Depression, hopelessness and social support among breast cancer patients: in highly endogamous population.Asian Pac. J. Cancer Prev. 2017; 18: 1889-1896
- Les relations familiales lors de maladies chroniques. Document à l’attention de l’APNP suite à une communication aux Journées Nationales 2017.Journées Nationales 2017, Paris2017
- Le Cancer. Une Personne Malade, Une Famille Souffrante.DUNOD, 2017
- Using the teach-back method in patient education to improve patient satisfaction.J. Contin. Educ. Nurs. 2017; 48: 47-52
- Testing a model of symptoms, communication, uncertainty, and well-being, in older breast cancer survivors.Res. Nurs. Health. 2006; 29: 18-39
- Holding it all together: breast cancer and its impact on life for younger women.Contemp. Nurse. 2006; 23: 157-169
- L’expérience du cancer pour les familles.Cah. Critiques Thérapie Fam. Pratiques Réseaux. 2006; 1: 81-101
- Sociologie du cancer.La Découverte, 2016
- Étude longitudinale du fonctionnement familial, de la détresse psychologique et des stratégies d’adaptation chez des patientes traitées pour un cancer du sein et leurs conjoints, lorsque des enfants jeunes vivent au sein de la famille: résultats de la première évaluation.Psycho-oncologie. 2012; 6: 163-168
- Living with breast cancer, a Lebanese experience.Eur. J. Oncol. Nurs. 2010; 14: 42-48
- Social support and coping means: the lived experiences of Northeastern Thai women with breast cancer.Health Promot. Int. 2017; 32: 768-777
- Breast cancer epidemiology among Lebanese women: an 11-year analysis.Medicina (Kaunas). 2019; 55: 463
- L’examen clinique de la famille: Modèles et instruments d’évaluation [Clinical examination of the family: Models and assessment tools].Editions Mardaga, Wavre2010
- Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study.JAMA Oncol. 2017; 3: 524-548
- SPSS for windows step by step: A simple study guide and reference, 17.0 update, 10/e.Pearson, 2011
- Psycho-oncology.Springer, 2018
- Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer.Support. Care Cancer. 2008; 16: 161-169
- Family communication and coping among racial-ethnic minority cancer patients: a systematic review.Health Soc. Care Community. 2021; 30: e605-e620
- (n.d. Rémission [Online]. Institut National Du Cancer,. Available:)https://www.e-cancer.fr/Patients-et-proches/Aider-un-proche-malade/Role-des-proches/RemissionDate accessed: May 28, 2022
- Social support and non-participation in breast cancer screening: a Danish cohort study.J. Public Health. 2016; 38: 335-342
- Autour du malade: la famille, le médecin et le psychologue.O. Jacob, 2002
- Factors associated with resilience of school age children with cancer.J. Paediatr. Child Health. 2010; 46: 431-436
- Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship--a multi-regional population-based study.Psychooncology. 2014; 23: 547-554
- From normal response to clinical problem: definition and clinical features of fear of cancer recurrence.Support. Care Cancer. 2016; 24: 3265-3268
- Communication, coping, and quality of life of breast cancer survivors and family/friend dyads: a pilot study of Chinese-Americans and Korean-Americans.Psychooncology. 2014; 23: 1243-1251
- Decisional conflict: relationships between and among family context variables in cancer survivors.Oncol. Nurs. Forum. 2016; 43: 480-488
- Family communication and mental health after breast cancer.Eur. J. Cancer Care. 2006; 15: 355-361
- Vivre après un cancer: un autre état de vulnérabilité?.Psycho-oncologie. 2013; 7: 23-29
- A controlled pilot trial of a nurse-led intervention (Mini-AFTERc) to manage fear of cancer recurrence in patients affected by breast cancer.Pilot Feasibility Stud. 2020; 6: 60
- Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors.Psychooncology. 2009; 18: 1273-1280
- A family-based model to predict fear of recurrence for cancer survivors and their caregivers.Psychooncology. 2007; 16: 214-223
- The impact of confounder selection criteria on effect estimation.Am. J. Epidemiol. 1989; 129: 125-137
- Le Malade, La Maladie, et Les Proches, Archipel.2009
- When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.Support. Care Cancer. 2016; 24: 4207-4218
- Circumplex Model VII: validation studies and FACES III.Fam. Process. 1986; 25: 337-351
- FACES IV & the Circumplex Model.Life Innovations, Inc, 2006
- Understanding the stress process of Chinese- and Korean-American breast cancer survivors.J. Immigr. Minority Health. 2016; 18: 1159-1167
- Psycho-oncologie: Le Cancer, Le Malade et Sa Famille.Masson, 2002
- Investigating the psychometric properties of the Arabic version of the family adaptability and cohesion evaluation scale IV (FACES IV) in Saudi arabia.J. Fam. Issues. 2021; 0192513X211033936
- Cancer statistics, 2018.CA A Cancer J. Clin. 2018; 68: 7-30
- Cancer statistics, 2020.CA: A Cancer Journal for Clinicians. 2020; 70: 7-30
- Fear of cancer recurrence: specific profiles and nature of intrusive thoughts.J. Cancer Surviv. 2010; 4: 361-371
- Pilot of a theoretically grounded psychologist-delivered intervention for fear of cancer recurrence (Conquer Fear).Psychooncology. 2015; 24: 967-970
- Does sharing good news buffer fear of bad news? A daily diary study of fear of cancer recurrence in couples approaching the first mammogram post-diagnosis.Psychooncology. 2018; 27: 2581-2586
- Evaluation of social support, quality of life, and body image in women with breast cancer.Breast Care. 2016; 11: 28-32
- Peur de la récidive et/ou progression du cancer et prévention en santé mentale.Psycho-oncologie. 2010; 4: 237-243
- Neuronal circuits for fear and anxiety.Nat. Rev. Neurosci. 2015; 16: 317-331
- The Concerns about Recurrence Scale (CARS): a systematic measure of women’s fears about the possibility of breast cancer recurrence.Ann. Behav. Med. 2003; 25: 16-24
- The impact of parental cancer on children and the family: a review of the literature.Cancer Treat Rev. 2004; 30: 683-694
- The need for Bayesian hypothesis testing in psychological science.in: LILIENFELD S. WALDMAN I. Psychological Science under Scrutiny: Recent Challenges and Proposed Solutions. John Wiley & Sons, Inc, 2017
- Process of translation and adaptation of instruments.([Online]. World Health Organization. Available:)https://www.who.int/substance_abuse/research_tools/translation/en/Date: 2020Date accessed: October 16, 2020
- The role of daily couple communication in the relationship between illness representation and fear of cancer recurrence in breast cancer survivors and their spouses.Psychooncology. 2019; 28: 1301-1307
- Exploring coping strategies among young Asian American women breast cancer survivors.J. Cancer Educ. 2017; 32: 43-50
Article Info
Publication History
Published online: July 02, 2022
Accepted:
June 30,
2022
Received in revised form:
June 6,
2022
Received:
February 4,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
