Does emotional talk vary with fears of cancer recurrence trajectory? A content analysis of interactions between women with breast cancer and their therapeutic radiographers

Barracliffe, L; Yang, Yuan; Cameron, Josie; Bedi, Carolyn; Humphris, Gerry

doi:10.1016/j.jpsychores.2018.01.004

Cited by 11 publications

(14 citation statements)

References 53 publications

(53 reference statements)

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“…The formulation of this merger would also reflect FCR's new consensus definition . Other support for the merger of cognition and emotions comes from recent reviews of the model by Lee‐Jones et al by Barracliffe et al The authors provide qualitative and diary support of the model by Lee‐Jones and their findings points to the parallel underplay of cognitions and emotions processed simultaneously when cancer survivors experience FCR. Reflecting on the many other FCR models that have emphasized the intertwined nature of cognition and emotions such as with the metacognition theory approach by Fardell et al, the proposed revised model again highlights this unique evolving empirical finding to FCR models.…”

Section: Discussionmentioning

confidence: 97%

Revision of the fear of cancer recurrence cognitive and emotional model by Lee‐Jones et al with women with breast cancer

et al. 2019

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Background Fear of cancer recurrence (FCR) is among the top unmet concerns reported by breast cancer survivors. Despite the sizable literature on FCR, few theoretical models have been empirically tested. One of the most cited is the FCR model. Aim This study seeks to understand the nature of women's cognitive and emotional issues from FCR using specific guidance from the model by Lee‐Jones and to provide suggestions for modifications to the model based on empirical results from the reported experiences of women living with breast cancer. Methods and results A qualitative descriptive study using semi‐structured interviews was conducted at an urban hospital. Recruited by convenience sampling, 12 breast cancer survivors concerned with FCR and who had recently completed active treatment participated in the study. Seven thematic categories emerged from the women's descriptions of their cognitive and emotional experiences with FCR: (a) FCR is always there; (b) beliefs about risk of recurrence; (c) beliefs about eradication of cancer; (d) preferences not to seek information about recurrence; (e) derailment of normal life; (f) worries related to recurrence; and (g) need for support. Adjustments to the model by Lee‐Jones et al1 specifically to women living with breast cancer include the addition of new variables—the fear is always present, a preference not to seek information, and the need for support beyond treatment—and the merging of two variables, anxiety and worry, as participants viewed these concepts as interchangeable and experienced in similar ways. Lastly, participants did not report any remorse related to not opting for more aggressive treatments. Conclusion The refinement of a more comprehensive FCR theoretical model, such as through the modifications derived from this study, provides a deeper understanding of breast cancer survivors' experiences with FCR and can more effectively guide health care professionals to develop appropriately tailored interventions aimed at decreasing FCR levels.

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Section: Discussionmentioning

confidence: 97%

Revision of the fear of cancer recurrence cognitive and emotional model by Lee‐Jones et al with women with breast cancer

et al. 2019

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“…Psychiatric disorder, non-English speaking, metastatic disease or consultant withdrawal were exclusion variables. Detailed sampling has been reported elsewhere [1]. See Appendix 1 for flow chart.…”

Section: Samplementioning

confidence: 99%

“…We have reported on the sequence of emotional cues that patients express and the type of response from Therapeutic Radiographers [16]. In addition, in a mixed-methods study we found that the expression of certain emotional content was linked to the FCR trajectory over radiotherapy treatment using a daily diary record [1]. Our interest was to explore the specific effects of patients raising emotional issues in appointments with their TR during their treatment.…”

Section: Introductionmentioning

confidence: 99%

Emotional talk of patients with breast cancer during review appointments with therapeutic radiographers: effects on fears of cancer recurrence

Humphris

Yang

Barracliffe

et al. 2018

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Fears of cancer recurrence (FCR) in patients with breast cancer may develop during radiotherapy. Radiographer communication with their patients may influence early survivorship FCR level. Aim To investigate the management of emotional talk in patients with breast cancer attending their initial review appointments during radiotherapy and predict FCR at 6-8 weeks follow-up. Methods A mixed methods observational study was conducted. Patients (consecutive sample, n = 60) with breast cancer, attending a major Scottish cancer centre, had their first two review appointments with their therapeutic radiographer (TR) audio-recorded. In addition, FCR was assessed (FCR7) at baseline and at 6-8 weeks following their final radiotherapy visit. Two TRs participated. Audio-files were coded by the VR-CoDES system to identify emotional cues and therapeutic radiographer (TR) responses. Linear regression models were tested for fit and to identify factors associated with follow-up FCR, i.e. patient cues, responses by TR. Results Follow-up FCR was predicted negatively (robust estimator, p = .01) by level of patient emotional talk at the second review session. The provision of space by the TR, at the second session, to enable patients to expand their emotional utterances was also associated, but negatively (p = .01), with follow-up FCR. These effects were maintained after inclusion of covariates: age, treatment received and living conditions. Conclusions Patient's emotional expression and TR responses at the second review meeting predicted follow-up FCR. The study shows the effect of communication processes on this specific distress component of the patient's survivorship experience.

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“…We have reported previously on 12 patients from the FORECAST study that completed daily diary ratings of FCR [18]. Selection of two types of patients was conducted, namely, those (n = 6) patients with a clear positive trajectory, i.e.…”

Section: Introductionmentioning

confidence: 99%

An observational mixed-methods approach to investigate the fear of cancer recurrence cognitive and emotional model by Lee-Jones et al with women with breast cancer during radiotherapy treatment

Millán

Cameron

Yang

et al. 2019

ecancer

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There is minimal qualitative research on fear of cancer recurrence (FCR) in patients who are still undergoing treatment. This study explored how breast cancer patients' illness beliefs changed during radiotherapy treatment, so as to provide their longitudinal perspective across sessions. These beliefs were mapped to Lee-Jones et al FCR model to assess its applicability to patients during this key treatment phase. A framework qualitative analysis was employed for verbatim interactions between patients (n = 8) and their radiographer (n = 2) over a minimum of three weekly review sessions (26 review consultations in total). Results proved suggested evolution and repetition of themes within and across sessions. Most themes were consistent with the early stages of the Lee-Jones et al model (antecedents and FCR) such as internal and external cues, cognitions and emotions. The crucial observation was that somatic stimuli were interpreted as side effects of radiotherapy treatment rather than cancer symptoms. Patients were still undergoing their last phase of major treatment, whereas the Lee-Jones et al model has been constructed to explain patients' past treatment experience. New themes emerged, including current exercise, concurrent illnesses/problems, cancer treatment as a constant reminder (of diagnosis) and associated sleeping difficulties. Decatastrophising of symptoms and experiences relating to cancer and its treatment was also a prominent theme indicating a possible coping mechanism to reduce worries about treatment side effects and associated experiences. Finally, some evidence was found from failure of emotional/fear processing in patients due to early surface reassurance by health professionals -a possible explanation of how FCR might arise. Early detection of FCR and promoting support while patients are still undergoing treatment might prevent patients from developing FCR after treatment.

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Does emotional talk vary with fears of cancer recurrence trajectory? A content analysis of interactions between women with breast cancer and their therapeutic radiographers

Abstract: The emotional content expressed matched features outlined in the Lee-Jones et al. (1997) FCR model, and showed evidence of avoidance in increasing FCR trajectory patients.

Cited by 11 publications

References 53 publications

Revision of the fear of cancer recurrence cognitive and emotional model by Lee‐Jones et al with women with breast cancer

Revision of the fear of cancer recurrence cognitive and emotional model by Lee‐Jones et al with women with breast cancer

Emotional talk of patients with breast cancer during review appointments with therapeutic radiographers: effects on fears of cancer recurrence

An observational mixed-methods approach to investigate the fear of cancer recurrence cognitive and emotional model by Lee-Jones et al with women with breast cancer during radiotherapy treatment

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