Preliminary Outcomes of a Culturally Adapted Fear of Recurrence Therapy (FORT) for Turkish Breast Cancer Survivors: A Randomized Controlled Trial
Psycho-Oncology, cilt.34, sa.12, 2025 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 34 Sayı: 12
- Basım Tarihi: 2025
- Doi Numarası: 10.1002/pon.70345
- Dergi Adı: Psycho-Oncology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE, Psycinfo
- Maltepe Üniversitesi Adresli: Evet
Özet
Background: Fear of cancer recurrence (FCR) is a major psychological burden for breast cancer survivors, impairing daily functioning and quality of life. Fear of Recurrence Therapy (FORT), a cognitive-behavioral group intervention, has shown efficacy in Western settings. This study evaluated the effectiveness of an adapted FORT program in Turkish breast cancer survivors. Methods: A single-blind, parallel-group randomized controlled trial was conducted between February and March 2025. Stage I–III survivors within 5 years post-treatment (N = 100) were randomized (1:1) to FORT or a CBT-based intervention. Both interventions comprised six weekly online sessions; however, the adapted version of FORT program was extended to 150 min per session, while the CBT group maintained 120-min sessions. The primary outcome was FCR (Fear of Cancer Recurrence Inventory). Secondary outcomes were anxiety and depression (HADS), distress (Emotion Thermometer), quality of life (EORTC QLQ-C30), intolerance of uncertainty (IUS-12), self-efficacy (SEMCD), and coping skills (CCQ). Analyses followed intention-to-treat (ITT) and per-protocol (PP) principles. Results: ITT analysis showed significant reductions in FCR in both groups; the ANCOVA-adjusted mean difference favoring FORT was −5.99 points (95% CI −10.95 to −1.03, p = 0.018, partial ω2 = 0.047). Between-group differences favored FORT on FCRI subscales (triggers, metacognitions, emotion-focused coping) and intolerance of uncertainty (F(1,95) = 2.174, p = 0.032). PP analysis indicated additional benefits for anxiety (F(1,84) = 5.735, p = 0.019), depression (t = −2.174, p = 0.032), and functional quality of life (z = −2.079, p = 0.038). Adherence was high, with most participants completing all sessions. Conclusions: Adapted FORT reduced FCR and psychological distress among Turkish survivors. Its effective online delivery demonstrates feasibility and scalability, supporting integration into psycho-oncological care. Trial registration: NCT06676228.