The relationships between fear of cancer recurrence, spiritual well-being and psychological resilience in non-metastatic breast cancer survivors during the COVID-19 outbreak.

Objectives: This study examines the relationships between fear of cancer recurrence (FCR), spiritual well-being (SWB) and psychological resilience in breast cancer survivors during the COVID-19 outbreak, and investigates to what extent breast cancer survivors' sociodemographic characteristics affect FCR, SWB and psychological resilience levels.

Methods: The study was conducted at Canakkale University Hospital in Turkey. Included in the study were 82 non-metastatic breast cancer patients whose clinical outcomes were followed-up after primary treatment, but suspended due to the COVID-19 outbreak. FCR, SWB and psychological resilience were assessed using the FCR inventory-short form (FCRI-SF), SWB scale and the brief resilience scale (BRS), respectively.

Results: The mean scores of breast cancer survivors concerning FCR, SWB, and psychological resilience were 17.77 ± 5.38, 36.20 ± 6.21 and 20.01 ± 4.51, respectively. A significant negative correlation was noted between the scores of FCR and SWB and psychological resilience (r = -0.329, p < 0.001 and r = -0.316, p = 0.004, respectively). Additionally, a significantly positive correlation was identified between psychological resilience and SWB (r = 0.501, p = 0.003). A hierarchical linear regression analysis with FCRI-SF as the dependent variable, and SWB and BRS as explanatory variables, indicated that SWB affects FCRI-SF scores and is a potential predictor of FCR. A mediation analysis revealed that SWB partially mediated the relationship between psychological resilience and FCR.

Conclusion: Breast cancer survivors with high SWB and psychological resilience scores experience less FCR, despite their failure to maintain the medical follow-up due to the COVID-19 outbreak. Efforts should be made to increase the psychological resilience and SWB of patients diagnosed with breast cancer.