title: Fear of recurrence: the importance of self-efficacy and satisfaction with care in gay men with prostate cancer.
abstract: OBJECTIVE
  Limited research has investigated the psychosocial processes that underpin the effect of physical symptoms on fear of cancer recurrence. Additionally, despite evidence of increased vulnerability of marginalized populations to negative outcomes, few studies have examined the unique experience of gay men coping with the cancer process. The goals of this study were to determine whether disease-related self-efficacy and satisfaction with medical care mediated the relationship between greater physical symptoms and worse fear of recurrence among gay or bisexual prostate cancer survivors.
  
  
  METHODS
  Participants were composed of 92 self-identified gay or bisexual men, who had received a diagnosis of prostate cancer in the past 4 years. Participants provided demographic information and completed self-report questionnaires that assessed symptom function, self-efficacy for prostate cancer symptoms, satisfaction with healthcare, and fear of recurrence. Bootstrapping procedures were used to assess for significant mediation.
  
  
  RESULTS
  Results suggested significant mediation of the relationship between each of bowel, hormonal, and sexual function with fear of recurrence by self-efficacy and satisfaction with healthcare. Mediation was not significantly supported for the association between urinary function and fear of recurrence.
  
  
  CONCLUSIONS
  Findings support the explanatory effects of self-efficacy for symptom management and satisfaction with healthcare on the relationship between symptom function and fear of recurrence. These results indicate that psychological processes, specifically psychological factors that hold particular relevance to gay or bisexual men, reflect a potential avenue for intervention to decrease fear of cancer recurrence.
authors: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors: Lindsey A
authors: LA
authors: Torbit
authors: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors: Jenna J
authors: JJ
authors: Albiani
authors: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors: Cassandra J
authors: CJ
authors: Crangle
authors: Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
authors: David M
authors: DM
authors: Latini
authors: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors: Tae L
authors: TL
authors: Hart
mesh_terms: D000223:Adaptation, Psychological; D001727:Bisexuality; D005239:Fear / Q000523:psychology*; D018451:Homosexuality, Male; D006801:Humans; D007410:Intestinal Diseases / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D020377:Self Efficacy; D012735:Sexual Dysfunction, Physiological / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014555:Urination Disorders / Q000523:psychology
keywords: fear of recurrence; gay men; prostate cancer; satisfaction with care; self-efficacy