Chen Fang, Jia Ruiying, Wang Qiutang, Li Min, Hong Su, Lan Meijuan, Zheng Leilei
Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Psychiatry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Front Psychol. 2025 Apr 30;16:1528189. doi: 10.3389/fpsyg.2025.1528189. eCollection 2025.
The COVID-19 pandemic caused by the SARS-CoV-2 virus is one of the most significant public health emergencies of this century. The rapid outbreak of COVID-19 infections has instilled fear in populations. Therefore, it is essential to investigate the risk factors and mechanisms associated with fear of progression (FoP) among individuals recovering from COVID-19. This information is crucial for alleviating the physical and psychological discomfort of individuals after recovery and enhancing their long-term quality of life.
A cross-sectional study involving 861 individuals recovering from COVID-19 was conducted in China from January to February 2023. The Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the Self-Rating Anxiety Scale, and the Fear of Progression Scale were utilized to assess mood status, sleep quality, and fear of progression. Receiver operating characteristic curves, Pearson's correlation analysis, binary logistic regression analysis, and Hayes' PROCESS Macro analysis were employed to test the model.
The results showed that sleep quality, anxiety, depression, and fear of progression were positively correlated, with coefficients ranging from 0.380 to 0.814. After addressing potential bias, sleep quality, anxiety, and depression emerged as risk factors for fear of progression (FoP). In the ROC curve analysis, these three factors predicted the occurrence of FoP (AUC: 0.646, 0.703, and 0.658, respectively). Anxiety and depression played a parallel mediating role between sleep quality and FoP, accounting for 59.9 and 13.8% of the total effect, respectively.
The results indicate that anxiety and depression both serve a parallel mediating role in the relationship between sleep quality and fear of pain (FoP). These findings provide potential guidance for the development and implementation of group-based interventions to address the mental health challenges of the post-COVID-19 era.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒引起的2019冠状病毒病（COVID-19）大流行是本世纪最重大的突发公共卫生事件之一。COVID-19感染的迅速爆发使民众心生恐惧。因此，调查COVID-19康复者中与疾病进展恐惧（FoP）相关的危险因素和机制至关重要。这些信息对于缓解康复后个体的身心不适以及提高其长期生活质量至关重要。
2023年1月至2月在中国对861名COVID-19康复者进行了一项横断面研究。采用匹兹堡睡眠质量指数、自评抑郁量表、自评焦虑量表和疾病进展恐惧量表来评估情绪状态、睡眠质量和疾病进展恐惧。采用受试者工作特征曲线、Pearson相关分析、二元逻辑回归分析和Hayes的PROCESS宏分析来检验模型。
结果显示，睡眠质量、焦虑、抑郁和疾病进展恐惧呈正相关，系数范围为0.380至0.814。在消除潜在偏差后，睡眠质量、焦虑和抑郁成为疾病进展恐惧（FoP）的危险因素。在ROC曲线分析中，这三个因素预测了FoP的发生（AUC分别为0.646、0.703和0.658）。焦虑和抑郁在睡眠质量和FoP之间起平行中介作用，分别占总效应的59.9%和13.8%。
结果表明，焦虑和抑郁在睡眠质量与疼痛恐惧（FoP）之间的关系中均起平行中介作用。这些发现为制定和实施基于群体的干预措施以应对COVID-19后时代的心理健康挑战提供了潜在指导。
