Study protocol of ConquerFear-HK: a randomised controlled trial of a metacognition-based, manualised intervention for fear of cancer recurrence among Chinese cancer survivors.

Amy Tien Yee Chang, Wendy Wing Tak Lam, Phyllis N Butow, Karen Kar Loen Chan, Oi-Kwan Chun, Miranda Chan, Dacita Suen, Simon Siu-Man Ng, Ava Kwong, Chi Choo Foo, Danielle Wing Lam Ng, Wylie Wai Yee Li, Julia Wei Chun Tang, Izy Wing Man Kong, Amy Or, Joyce Chan, Carmen Ng, Catherine Tsang, Richard Fielding

Journal: BMJ open 2023;13(1):e065075

PMID: 36669845

Abstract

INTRODUCTION

Fear of cancer recurrence (FCR) is a prevalent and frequently debilitating response to a cancer diagnosis, affecting a substantial proportion of cancer survivors. Approximately 30% of local Hong Kong Chinese cancer survivors in a recent survey reportedly experienced persistent high FCR over the first-year post-surgery. This was associated with lower levels of psychological well-being and quality of life. A manualised intervention (ConquerFear) developed primarily based on the Self-Regulatory Executive Function Model and the Rational Frame Theory, has been found to reduce FCR effectively among Caucasian cancer survivors. The intervention now has been adapted to a Chinese context; ConquerFear-HK. The primary aim of this study is to evaluate its efficacy vs a standard-survivorship-care control (BasicCancerCare) in FCR improvement in a randomised control trial (RCT).

METHODS AND ANALYSIS

In this RCT, using the sealed envelope method, 174 eligible Chinese cancer survivors will be randomised to either the ConquerFear-HK or BasicCancerCare intervention. Both interventions include six sessions over 10 weeks, which will be delivered via face to face or online by trained therapists. The ConquerFear-HK intervention incorporates value classification, metacognitive therapy, attentional training, detached mindfulness and psychoeducation; BasicCancerCare includes relaxation training, dietary and physical activity consultations. Participants will be assessed at prior randomisation (baseline; T0), immediately postintervention (T1), 3 months (T2) and 6 months postintervention (T3) on the measures of FCR (Fear of Cancer Recurrence Inventory) as a primary outcome; metacognition (30-item Metacognitions Quesionnaire) and cognitive attentional syndrome (Cognitive-attentional Syndrome Questionnaire) as process outcomes; psychological distress (Hospital Anxiety and Depression Scale), cancer-related distress (Chinese Impact of Events Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire) and treatment satisfaction are secondary outcomes.

ETHICS AND DISSEMINATION

Ethics approval has been obtained from HKU/HA HKW Institutional Review Board (ref: UW19-183). The patients/participants provide their written informed consent to participate in this study. The study results will be disseminated through international peer-review publications and conference presentations.

TRIAL REGISTRATION NUMBER

NCT04568226.

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Address: Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong.; HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.; Department of Clinical Oncology, The University of Hong Kong, Hong Kong, Hong Kong.; Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong.; Department of Surgery, The Chinese University of Hong Kong, New Territories, Hong Kong.; Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong.; Department of Obstetric and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong.; Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.; Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong [email protected].
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