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Fear of Progression in Outpatients With Chronic Myeloid Leukemia on Oral Tyrosine Kinase Inhibitors

Jochen Hefner
Eva-Johanna Csef
Volker Kunzmann
ONF 2016, 43(2), 190-197 DOI: 10.1188/16.ONF.190-197

Purpose/Objectives: To assess fear of progression (FoP) in outpatients with chronic myeloid leukemia (CML) on oral tyrosine kinase inhibitors (TKIs).

Design: Prospective and descriptive.

Setting: A university-based outpatient cancer clinic in Wuerzburg, Germany.

Sample: 37 outpatients with CML on oral TKIs.

Methods: FoP was assessed with a questionnaire. Clinical data were extracted from the medical charts.

Main Research Variables: Frequency and contents of FoP.

Findings: Sum scores and levels of FoP in the sample population (N = 37) were as high as in cancer populations with more unfavorable life expectancies. Regarding single items, fear that medication may harm the body was most prevalent, regardless of group affiliation. The actual fear of disease progression was only ranked sixth out of 12 items for the total sample and was ranked second by the second-generation TKI group.

Conclusions: In a sample of outpatients with CML, FoP was frequent and most often generated by fears of treatment side effects.

Implications for Nursing: Nurses should be vigilant about FoP in this population. Established questionnaires may help to identify and evaluate this frequent source of distress. Specific communication could reveal unmet informational needs and may help to initiate interventions. Additional studies are needed to confirm the numbers in a larger cohort of patients, to examine the prevalence during the course of disease, to search for potential influences on the outcome (i.e., via adherence), and to extract the best interventions.

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