Li Jia, He Yi, Xie Fei, Kang Zhiming, Mei Jing, Mei Bin
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
BMC Psychiatry. 2025 Aug 12;25(1):780. doi: 10.1186/s12888-025-07242-z.
Fear of progression (FoP) has been well-documented in patients with cancer and chronic disease. However, there is little information in stroke patients. The purpose of this study was to explore the profiles and associated factors of FoP among ischemic stroke survivors, and to examine the association of FoP profiles with quality of life (QoL) and depression.
A cross-sectional study was conducted from July 2023 to June 2024. Two hundred ischemic stroke survivors were recruited. Data collection included a self-designed sociodemographic and clinical information questionnaire, the Fear of Progression Questionnaire-Short Form, the Stroke Specific Quality of Life Scale, and the Self-Rating Depression Scale. Latent profile analysis (LPA), univariate analysis, multinomial logistic regression analysis, and multiple hierarchical regression analysis were adopted in this study.
LPA identified three subgroups of FoP: Group 1-the low FoP (23%), Group 2-the moderate FoP with family-related concerns (45%), and Group 3-the high FoP with work-related concerns (32%). Older age (OR = 0.245, p = 0.003) and lower functional independence (Barthel index, BI) (OR = 0.976, p = 0.034) were associated with Group 2, while younger age (OR = 8.771, p = 0.018) and lower monthly family income (OR = 9.960, p = 0.004) were associated with Group 3. FoP profiles explained 3.0% variance in QoL and 3.3% variance in depression (p < 0.05). Group 2 and 3 showed significantly lower QoL than Group 1 (p < 0.05), while Group 2 and Group 3 had higher depression than Group 1 (p < 0.05).
Three heterogeneous subgroups of FoP were identified in ischemic stroke survivors. Age, household monthly income, and functional independence were associated with different latent profiles of FoP. Healthcare providers should categorize patients with FoP into subgroups and provide targeted interventions based on each profile's characteristics and associated factors. This could contribute to promoting their QoL and lowering their depression.
癌症和慢性病患者中对病情进展的恐惧（FoP）已有充分记录。然而，关于中风患者的相关信息却很少。本研究的目的是探讨缺血性中风幸存者中FoP的特征及相关因素，并检验FoP特征与生活质量（QoL）和抑郁之间的关联。
于2023年7月至2024年6月进行了一项横断面研究。招募了200名缺血性中风幸存者。数据收集包括自行设计的社会人口学和临床信息问卷、病情进展恐惧问卷简表、中风特异性生活质量量表和自评抑郁量表。本研究采用了潜在剖面分析（LPA）、单因素分析、多项逻辑回归分析和多重分层回归分析。
LPA识别出FoP的三个亚组：第1组——低FoP组（23%），第2组——有家庭相关担忧的中度FoP组（45%），第3组——有工作相关担忧的高FoP组（32%）。年龄较大（OR = 0.245，p = 0.003）和功能独立性较低（巴氏指数，BI）（OR = 0.976，p = 0.034）与第2组相关，而年龄较小（OR = 8.771，p = 0.018）和家庭月收入较低（OR = 9.960，p = 0.004）与第3组相关。FoP特征解释了QoL中3.0%的方差和抑郁中3.3%的方差（p < 0.05）。第2组和第3组的QoL显著低于第1组（p < 0.05），而第2组和第3组的抑郁程度高于第1组（p < 0.05）。
在缺血性中风幸存者中识别出了三个不同的FoP亚组。年龄、家庭月收入和功能独立性与FoP的不同潜在特征相关。医疗服务提供者应将有FoP的患者分为亚组，并根据每个亚组的特征和相关因素提供针对性干预。这有助于提高他们的QoL并降低他们的抑郁程度。
