Fear of recurrence: the importance of self-efficacy and satisfaction with care in gay men with prostate cancer

Abstract

Objective Limited research has investigated the psychosocial processes that underpin the effect of physical symptoms on fear of cancer recurrence. Additionally, despite evidence of increased vulnerability of marginalized populations to negative outcomes, few studies have examined the unique experience of gay men coping with the cancer process. The goals of this study were to determine whether disease-related self-efficacy and satisfaction with medical care mediated the relationship between greater physical symptoms and worse fear of recurrence among gay or bisexual prostate cancer survivors. Methods Participants were composed of 92 self-identified gay or bisexual men, who had received a diagnosis of prostate cancer in the past 4 years. Participants provided demographic information and completed self-report questionnaires that assessed symptom function, self-efficacy for prostate cancer symptoms, satisfaction with healthcare, and fear of recurrence. Bootstrapping procedures were used to assess for significant mediation. Results Results suggested significant mediation of the relationship between each of bowel, hormonal, and sexual function with fear of recurrence by self-efficacy and satisfaction with healthcare. Mediation was not significantly supported for the association between urinary function and fear of recurrence. Conclusions Findings support the explanatory effects of self-efficacy for symptom management and satisfaction with healthcare on the relationship between symptom function and fear of recurrence. These results indicate that psychological processes, specifically psychological factors that hold particular relevance to gay or bisexual men, reflect a potential avenue for intervention to decrease fear of cancer recurrence.

Care delivery, patient experiences, and health outcomes among sexual and gender minority patients with cancer and survivors: A scoping review

“…Six studies focused on quality of care from the perspective of SGM patients with cancer . An online study of survivor perceptions found lower satisfaction with cancer care among SMs compared with their heterosexual counterparts .…”

Factors influencing fear of cancer recurrence in patients with breast cancer: Evidence from a survey in Yancheng, China

“…Patients with FCR often have the following characteristics: Thoughts associated with death, feeling lonely, believing that cancer will recur, uncertain experiences, the emergence of uncontrollable thoughts and images associated with cancer, and the thoughts often occur every day and last longer than 30 min . The previous studies have confirmed that FCR is concurrent with a significantly lower quality of life (QOL), functional impairments, and increased use and cost of health care.…”

“…In recently published studies, a variety of factors were found to be associated with the cancer patients’ FCR level. Demographic characteristics such as female gender, young age, living apart or divorce, a higher level of education, and no children have been reported to be related to higher FCR.…”

Sexual minority experiences of cancer care: A systematic review

“…The ways in which LGB individuals are affected by cancer and how they cope were discussed within several papers, indicating many sexual minority attitudes are common with heterosexual cancer survivors, but sexual minorities may report poorer health [24,[26][27][28]53,54].…”

“…A Canadian study examined SMM Fear of Reoccurrence (FOR) and noted that there was a relationship between (FOR) and the initial physical presenting symptoms of their cancer [26]. Ninety-two SMM with various cancer types completed self-report questionnaires that assessed symptom function, self-efficacy for prostate cancer symptoms, and FOR.…”