Browsing by Author "Fenech, Alyssa L."
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Item Fear of cancer recurrence, anxiety, and depression among patients with head and neck cancer: a latent change score analysis(University of Delaware, 2023) Fenech, Alyssa L.Patients with head and neck cancer frequently report some of the highest levels of psychological distress amid managing their disease as well as debilitating and disfiguring treatment side effects. Symptoms of anxiety and depression are common among patients with cancer, but chronic symptoms may lead to impairments in quality of life and emotional health. Fear of cancer recurrence (FCR) is a top unmet need and concern of patients with head and neck cancer. Prior research suggests symptoms of anxiety and depression are potential antecedents to FCR, but findings have been limited to mostly cross-sectional studies in small samples. Utilizing data collected through the Head and Neck 5000 Study in the United Kingdom, the objective of the present study was to examine early level and change in symptoms of anxiety and depression in relation to later change in FCR among patients with head and neck cancer during the first year after diagnosis. A sample of 4891 patients from the parent study completed self-report longitudinal assessments of anxiety, depression, and FCR around the time of diagnosis and 4 and 12 months later. Utilizing a multiple indicator latent change score model, results revealed baseline anxiety level and increases in anxiety from baseline to 4 months were positively associated with change in FCR from 4 to 12 months. Neither baseline depression nor change in depression from baseline to 4 months were significantly associated with later FCR change. Findings suggest that early level and increases in symptoms of anxiety may be a marker of later FCR development. Future research should consider anxiety as a unique antecedent and maintaining factor of FCR and interventions targeting anxiety early in the cancer trajectory may have downstream effects on FCR development.Item Psychosocial Impact of Cancer Care Disruptions in Women With Breast Cancer During the COVID-19 Pandemic(Frontiers in Psychology, 2021-06-14) Soriano, Emily C.; Perndorfer, Christine; Otto, Amy K.; Fenech, Alyssa L.; Siegel, Scott D.; Dickson-Witmer, Diana; Clements, Lydia; Laurenceau, Jean-PhilippeBackground: The COVID-19 pandemic caused significant disruptions in cancer care, and preliminary research suggests that these disruptions are associated with increased levels of psychosocial distress among cancer survivors. The purpose of this study was to offer a descriptive report of the psychosocial functioning, perceived risk and fear of cancer progression, and COVID-19 pandemic impact and experiences in a unique, high-risk patient cohort: breast cancer survivors whose cancer treatment was delayed and/or changed due to the COVID-19 pandemic. Methods: This cross-sectional study included 50 women with dual carcinoma in situ, lobular carcinoma in situ, or invasive breast cancer whose cancer surgery was postponed due to the pandemic. As they awaited delayed surgery or shortly after they received delayed surgery, participants completed questionnaires on psychosocial functioning (depression, anxiety, sleep, and quality of life), their perceived risk and fear of cancer progression, patient-provider communication about disruptions in their care, personal impact of the pandemic, worry/threat about COVID-19, and COVID-19 symptoms/diagnoses. Descriptive statistics and bivariate correlations were computed among continuous study variables. Independent samples t-tests explored group differences in psychosocial functioning between survivors who were still awaiting delayed surgery and those who had recently received it. Results: Overall, the sample denied that the pandemic seriously negatively impacted their finances or resource access and reported low-to-moderate levels of psychosocial distress and fear about COVID-19. Twenty-six percent had clinically significant levels of fear of cancer progression, with levels comparable to other recent work. About a third were still awaiting delayed cancer surgery and this group reported lower satisfaction with communication from oncology providers but overall did not seem to report more psychosocial difficulties than those who already had surgery. Conclusion: Shortly before or after primary breast cancer surgery that was delayed due to the COVID-19 pandemic, this sample of survivors appears to be generally managing well psychosocially. However, many psychosocial difficulties (e.g., fear of cancer recurrence/progression) typically have an onset after the completion of treatment, therefore, research should continue to follow this cohort of cancer survivors as the pandemic’s direct impact on their care likely increases their risk for these difficulties later in survivorship.