IF 3.8 3区 医学 Q1 NURSING Journal of Advanced Nursing Pub Date : 2025-01-26 DOI:10.1111/jan.16784
Shangqing Wu, Dongbao Yang
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By highlighting the correlation between high FCR and reproductive anxieties, the authors provide critical insights into a vulnerable patient group that requires a multidisciplinary approach to care. These findings emphasise the need for tailored interventions, such as psychological counselling and reproductive health support, to mitigate distress and address the unique needs of this demographic. The study's results have important implications for clinical practice, particularly in developing holistic survivorship care plans that integrate oncological, psychological and reproductive health services. Future research should explore the long-term impact of these interventions and further refine strategies to support breast cancer survivors in this age group. We commend the authors for their valuable contribution and would like to share some additional perspectives on strategies to further reduce the risk of fear of cancer recurrence in this patient population. We propose addressing this issue through approaches focused on medical and nursing care, family and social support, as well as national policies.</p>\n<p>First, healthcare professionals play a pivotal role in alleviating FCR among breast cancer patients of reproductive age. A key strategy involves establishing structured and regular follow-up programmes that provide continuous monitoring and personalised care. These programs not only help detect recurrence at an early stage but also instil confidence in patients by ensuring that their condition is being closely managed. Additionally, offering clear and transparent communication about recurrence risks is essential. Patients who receive accurate and understandable information about their prognosis and potential risks are less likely to experience uncertainty and anxiety, as such communication fosters a sense of trust and empowerment. Psychological counselling is another critical component, as it directly addresses the emotional and cognitive aspects of FCR. Trained mental health professionals can help patients develop coping mechanisms to manage their fears, reduce distress and improve overall well-being. Integrating multidisciplinary teams—comprising oncologists, fertility specialists, psychologists, nurses and social workers—ensures that physical, psychological and reproductive health concerns are addressed comprehensively. This holistic approach is particularly important for patients of reproductive age, as it balances oncological treatment needs with reproductive and mental health support, ultimately improving quality of life.</p>\n<p>Second, emotional support from family members and friends plays a critical role in helping breast cancer patients manage FCR (Maheu et al. <span>2019</span>; Chen et al. <span>2022</span>). 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引用次数: 0

摘要

Liu 等人(2024 年)最近调查了育龄乳腺癌患者对癌症复发的恐惧(FCR)及其与生育问题的关联。通过潜在特征分析,他们确定了具有不同程度 FCR 的不同患者亚群,揭示了 FCR 在这一人群中表现形式的显著异质性。值得注意的是,FCR 升高的患者更有可能表达出对生育和未来怀孕的高度担忧。这项研究强调了年轻乳腺癌幸存者的心理和生殖健康问题之间复杂的相互作用。通过强调高 FCR 与生殖焦虑之间的相关性,作者对需要多学科护理的弱势患者群体提供了重要的见解。这些研究结果强调,有必要采取有针对性的干预措施,如心理咨询和生殖健康支持,以减轻患者的痛苦并满足这一人群的独特需求。研究结果对临床实践具有重要意义,尤其是在制定整合肿瘤、心理和生殖健康服务的整体幸存者护理计划方面。未来的研究应探讨这些干预措施的长期影响,并进一步完善支持这一年龄组乳腺癌幸存者的策略。我们对作者的宝贵贡献表示赞赏,并希望与大家分享一些关于进一步降低这一患者群体癌症复发恐惧风险的策略的其他观点。我们建议通过侧重于医疗和护理、家庭和社会支持以及国家政策的方法来解决这一问题。首先,医护人员在减轻育龄乳腺癌患者的 FCR 方面发挥着关键作用。首先,医护人员在减轻育龄乳腺癌患者的复发率方面发挥着关键作用。一项关键策略是建立结构化的定期随访计划,提供持续监测和个性化护理。这些计划不仅有助于及早发现复发,还能确保患者的病情得到密切控制,从而增强患者的信心。此外,就复发风险进行清晰透明的沟通也至关重要。患者如果能获得有关其预后和潜在风险的准确、易懂的信息,就不太可能感到不确定和焦虑,因为这种沟通能培养患者的信任感和能力。心理咨询是另一个重要组成部分,因为它直接涉及 FCR 的情感和认知方面。训练有素的心理健康专业人员可以帮助患者建立应对机制,以控制恐惧、减少痛苦并改善整体健康。由肿瘤专家、不孕不育专家、心理学家、护士和社会工作者组成的多学科团队可确保全面解决患者的生理、心理和生殖健康问题。这种综合方法对育龄患者尤为重要,因为它能平衡肿瘤治疗需求与生殖和心理健康支持,最终提高生活质量。其次,家人和朋友的情感支持在帮助乳腺癌患者管理 FCR 方面发挥着至关重要的作用(Maheu 等,2019 年;Chen 等,2022 年)。患者的心理健康受到其人际关系质量的强烈影响,因为支持性环境有助于减轻焦虑和培养复原力。让家人了解癌症幸存者面临的独特心理挑战至关重要,例如对复发的恐惧和对未来的担忧。通过提高家庭成员的认识和理解,患者更有可能获得同情和情感认同,这是减少孤独感和痛苦的关键。一个强大、信息灵通的家庭支持系统可以提供一种稳定感和安全感,从而大大减轻 FCR 所带来的情感伤害。在社交方面,同侪支持小组和幸存者网络提供了更多管理 FCR 的途径。通过这些平台,患者可以与有类似经历的人建立联系,在一个没有评判的空间里公开讨论自己的恐惧。通过共同理解和相互鼓励,患者可以将自己的情绪正常化,并建立心理复原能力。这些小组还通过展示积极应对策略和长期生存的实例来增强患者的能力。第三,政府和医疗保健系统通过实施优先考虑幸存者护理的政策,在降低乳腺癌幸存者的 FCR 方面发挥着至关重要的作用。
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Comment on ‘Latent Profiles of Fear of Cancer Recurrence in Breast Cancer Patients of Reproductive Age and Associations With Reproductive Concerns’

Liu et al. (2024) recently investigated the fear of cancer recurrence (FCR) among breast cancer patients of reproductive age and its associations with reproductive concerns. Using latent profile analysis, they identified distinct subgroups of patients with varying levels of FCR, revealing significant heterogeneity in how FCR manifests within this population. Notably, patients with elevated FCR were more likely to express heightened concerns about fertility and future pregnancies. This study underscores the complex interplay between psychological and reproductive health concerns in younger breast cancer survivors. By highlighting the correlation between high FCR and reproductive anxieties, the authors provide critical insights into a vulnerable patient group that requires a multidisciplinary approach to care. These findings emphasise the need for tailored interventions, such as psychological counselling and reproductive health support, to mitigate distress and address the unique needs of this demographic. The study's results have important implications for clinical practice, particularly in developing holistic survivorship care plans that integrate oncological, psychological and reproductive health services. Future research should explore the long-term impact of these interventions and further refine strategies to support breast cancer survivors in this age group. We commend the authors for their valuable contribution and would like to share some additional perspectives on strategies to further reduce the risk of fear of cancer recurrence in this patient population. We propose addressing this issue through approaches focused on medical and nursing care, family and social support, as well as national policies.

First, healthcare professionals play a pivotal role in alleviating FCR among breast cancer patients of reproductive age. A key strategy involves establishing structured and regular follow-up programmes that provide continuous monitoring and personalised care. These programs not only help detect recurrence at an early stage but also instil confidence in patients by ensuring that their condition is being closely managed. Additionally, offering clear and transparent communication about recurrence risks is essential. Patients who receive accurate and understandable information about their prognosis and potential risks are less likely to experience uncertainty and anxiety, as such communication fosters a sense of trust and empowerment. Psychological counselling is another critical component, as it directly addresses the emotional and cognitive aspects of FCR. Trained mental health professionals can help patients develop coping mechanisms to manage their fears, reduce distress and improve overall well-being. Integrating multidisciplinary teams—comprising oncologists, fertility specialists, psychologists, nurses and social workers—ensures that physical, psychological and reproductive health concerns are addressed comprehensively. This holistic approach is particularly important for patients of reproductive age, as it balances oncological treatment needs with reproductive and mental health support, ultimately improving quality of life.

Second, emotional support from family members and friends plays a critical role in helping breast cancer patients manage FCR (Maheu et al. 2019; Chen et al. 2022). The psychological well-being of patients is strongly influenced by the quality of their interpersonal relationships, as supportive environments can help mitigate anxiety and foster resilience. Educating families about the unique psychological challenges faced by cancer survivors, such as fears of recurrence and concerns about the future, is essential. By increasing awareness and understanding among family members, patients are more likely to receive empathy and emotional validation, which are key to reducing feelings of isolation and distress. A strong, well-informed support system at home provides a sense of stability and security that can significantly buffer against the emotional toll of FCR. Socially, peer support groups and survivor networks offer additional avenues for managing FCR. These platforms allow patients to connect with others who share similar experiences, enabling them to openly discuss their fears in a judgement-free space. Through shared understanding and mutual encouragement, patients can normalise their emotions and build psychological resilience. These groups also promote empowerment by showcasing examples of positive coping strategies and long-term survivorship. Together, family support and peer networks provide complementary layers of emotional reinforcement critical for addressing FCR in breast cancer survivors.

Third, governments and healthcare systems play an essential role in reducing FCR among breast cancer survivors by implementing policies that prioritise survivorship care. One critical strategy is the expansion of access to mental health services, ensuring that psychological support is integrated into survivorship care plans. Affordable and readily available counselling services can help patients develop effective coping mechanisms to manage FCR, ultimately improving their mental health outcomes. Offering financial support for fertility preservation treatments is another important consideration, as reproductive concerns are a major source of distress for patients of reproductive age. Subsidising or covering these treatments can alleviate the financial burden, allowing patients to focus on their recovery without added stress about future family planning. Additionally, public awareness campaigns targeted at reducing stigma and increasing knowledge about survivorship challenges can empower patients and normalise their experiences, fostering a more supportive societal environment. Incorporating survivorship care plans into national cancer care guidelines ensures standardised, high-quality care across institutions. Such plans can include regular follow-ups, mental health screenings, reproductive counselling and lifestyle interventions tailored to the specific needs of survivors. These measures collectively enhance the overall quality of life and long-term outcomes for breast cancer survivors by addressing both physical and emotional health concerns.

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来源期刊
CiteScore
6.40
自引率
7.90%
发文量
369
审稿时长
3 months
期刊介绍: The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.
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