Relationships Between Fear of Cancer Recurrence, Unmet Healthcare Needs, and Quality of Life Among Thai Breast Cancer Survivors Post-Treatment

Abstract

Highlights: What are the main findings? Fear of cancer recurrence and unmet healthcare needs were significantly associated with poorer overall quality of life among Thai breast cancer survivors after treatment. No significant association was found between fear of cancer recurrence and unmet healthcare needs, suggesting distinct psychosocial processes in survivorship. What are the implications of the main findings? Survivorship care should integrate psychological and supportive care services to address fear of cancer recurrence and unmet healthcare needs, with attention to improving access to psychosocial care and survivorship education. Healthcare systems and survivorship programs may reduce disparities by implementing culturally tailored follow-up services and routine psychological assessment during the post-treatment phase. Purpose: This study examined the relationships among fear of cancer recurrence (FCR), unmet healthcare needs, and quality of life (QOL) among breast cancer survivors post-treatment, particularly within the Thai cultural and healthcare context, where limited research has been conducted. Methods: A cross-sectional descriptive correlational design with purposive sampling was used. A total of 122 breast cancer survivors, 1–5 years prior, were recruited from the Breast Clinic and Chemotherapy Unit at the National Cancer Institute. Instruments included a demographic questionnaire, the FCR Inventory Short Form, the Cancer Survivors’ Unmet Needs measure, and the EORTC QOL-C30 with the breast cancer module (QLQ-BR23). Cronbach’s α ranged from 0.82 to 0.92. Data were analyzed using descriptive statistics, Spearman’s rank correlation, and Pearson’s correlation coefficient. Results: Participants reported moderate levels of FCR (M = 13.39, SD = 4.50), low unmet healthcare needs (M = 25.63, SD = 14.82), and moderate overall QOL (M = 54.82, SD = 0.22). FCR was negatively correlated with overall QOL (r = −0.248, p <0.01) and functional QOL (r = −0.242, p < 0.01). Unmet healthcare needs were also negatively correlated with overall QOL (r = −0.261, p < 0.01). Multiple linear regression analysis revealed that both FCR and unmet healthcare needs had a significantly negative relationship with overall QOL (p < 0.05). Conclusions: FCR and unmet healthcare needs independently impair QOL among breast cancer survivors. Early, culturally appropriate survivorship care in Asian contexts is essential to address these needs and improve QOL.