Evaluation of two group therapies to reduce fear of progression in cancer patients

• Published in: Supportive care in cancer Vol. 18; no. 4; pp. 471 - 479
• Main Authors: Herschbach, Peter, Book, Katrin, Dinkel, Andreas, Berg, Petra, Waadt, Sabine, Duran, Gabriele, Engst-Hastreiter, Ursula, Henrich, Gerhard
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-04-2010; Springer; Springer Nature B.V
• Subjects: Adult; Analysis; Anxiety - etiology; Cancer; Cancer patients; Care and treatment; Cognitive Therapy - methods; Depression - etiology; Disease Progression; Effectiveness studies; Fear; Fear & phobias; Female; Follow-Up Studies; Group therapy; Humans; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - physiopathology; Neoplasms - psychology; Neoplasms - rehabilitation; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Psychiatric Status Rating Scales; Psychometrics; Psychotherapy, Group - methods; Quality of Life; Rehabilitation Medicine; Surveys and Questionnaires; Time Factors; Controlled trial; Psychosocial oncology; Group therapy; Fear of progression; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-009-0696-1

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.