Trajectory Analysis and Influencing Factors of Fear of Cancer Recurrence Discrepancies Between Colorectal Cancer patients and Their Caregivers

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Abstract

Objective To explore the potential categories of fear of cancer recurrence (FCR) discrepancy trajectories between colorectal cancer patients and their caregivers and identify the influencing factors. Methods A multicenter stratified random sampling method was employed to recruit colorectal cancer patients who underwent radical surgery and their caregivers from three tertiary oncology hospitals in Shanghai between October 2022 and March 2024. Data were collected using general information questionnaires, the Chinese version of the Fear of Disease Progression-Short Form (FoP-Q-SF), the Spousal Fear of Disease Progression-Short Form, and the Social Support Rating Scale. Baseline assessments of demographic characteristics, FCR, and social support were conducted one day before discharge. FCR levels were subsequently evaluated at 3、6 and 9 months post-surgery. Latent growth mixture modeling was used to identify distinct trajectories of FCR discrepancies between patients and caregivers, while multivariate logistic regression was applied to analyze influencing factors for different trajectory categories. Results Three heterogeneous developmental trajectories of FCR discrepancies between colorectal cancer patients and their caregivers were identified: stable discrepancy group (40.6%), widening discrepancy group (35.5%), and converging discrepancy group (23.8%). Multivariate regression analysis revealed that monthly household income percapita <¥5000, low social support, presence of stoma, and multiple comorbidities were significant factors associated with widening FCR discrepancies. Conversely, high social support, absence of stoma, and fewer comorbidities promoted convergence in FCR discrepancies. Conclusion The developmental trajectories of FCR discrepancies between colorectal cancer patients and their caregivers demonstrate distinct heterogeneity patterns. Healthcare professionals should accurately identify intervention targets based on trajectory characteristics and influencing factors, develop and implement tailored interventions to reduce FCR levels in both patients and caregivers, ultimately improving their quality of life and care outcomes.

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