Breast Cancer Clinical Trial
Official title:
Fear of Cancer Recurrence (FoR) Trajectory During Radiation Treatment and Follow-up Into Survivorship of 100 Breast Cancer patients-a Pilot Study
This pilot study concentrates on studying the trajectory of breast cancer patient's fear of recurrence (FoR) over the course of radiation therapy. The aim is to collect repeated ratings of 100 breast cancer patient's FoR over the course of their treatment. It is hypothesized that cancer patient's FoR level will rise on nearing the termination of the in radiotherapy treatment, and radiotherapist-patient interaction modifies the development of patient's FoR.
The aim of this pilot study is to examine the collection of FoR levels in a longitudinal
design with 100 breast cancer patients receiving radiotherapy for their disease. In this
study, an intensive longitudinal design will be employed (Bolger & Laurenceau, 2013). There
will be two data collection types. First, will be self-reported questionnaires. Patients will
complete questions including three sections: 1) demographic information (i.e. age, education,
employment, marital/family status), 2) a 7-item FoR scale (ACCRE FCR) and 3) a 20-item Affect
Schedule (PANAS) before first radiation treatment (T1). Throughout the period of treatment, a
3-item FoR questionnaire (ACCRE FCR 3 Items) will be designed as a daily diary to monitor
patient's FoR level. Then, at the end of the radiotherapy treatment (T2), PANAS will be
measured again. Finally, six-eight weeks after the end of the treatment (T3), all
participants will be asked to complete the 7-items FCR questionnaire once again as well as a
5-item EuroQoL EQ-5D-3L scale by telephone.
The second data collection media is audiotape. The conversations between radiotherapist and
patient in the weekly review appointment will be recorded and a behavioural coding system
(VR-CoDES) will be used to analyse the interactions between patient and radiotherapist.
Data analysis will involve statistical analysis and qualitative methods. Statistical analyses
will be conducted using Statistical Package for the Social Sciences (SPSS) Analytics software
v.22, Analysis of MOment Structures (AMOS) v.22 and MPlus™ (SEM: Structural Equation
Modelling). Initial analysis will plot individual and group average curves over the days that
patients are treated. The analysis will develop a statistical model based upon SEM principles
of growth curves. Each patient is expected to disclose increased fears of recurrence over the
course of treatment. Latent curve modelling will be developed to test the relationship of FoR
over the time course of the treatment.
As part of this pilot study the investigators wish to investigate the appropriateness of
these models and to test the extent of growth of FoR to the outcome at 6-8 weeks follow up,
using the FoR 7 item measure. Covariates will be introduced for control purposes and indicate
initial level of negative affectivity (The Positive and Negative Affect Schedule - PANAS),
age and initial level of disease severity. Alternative strategies of analysis are considered
appropriate and may enable a parallel strategy. This would involve a simpler approach
concentrating on the raw data. Linear modelling (multi-level) which will include estimation
of linear slopes being used to predict FoR outcome.
Audio recordings of the consultation will be transcribed verbatim in order to investigate how
the radiotherapist-patient communication affects the development of FoR.
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