Factors Influencing The Fear Of Disease Progression In Patients With Rheumatic Diseases Based On Structural Equation Model

Objective:The aim of this study is to understand the current status of fear of disease progression among patients with rheumatic diseases,and identify the influencing factors of fear of disease progression in patients with rheumatic diseases,in order to provide a theoretical basis for reducing patients’fear of disease progression,and guide clinical healthcare professionals in developing targeted intervention measures.Methods:In this study,a cross-sectional design was adopted,and patients with rheumatic diseases were selected from the inpatients of the Rheumatology and Immunology Department at a tertiary hospital in Shenyang.The survey instruments included the General Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form,the Functional Assessment of Chronic Disease and Treatment-Fatigue Scale,the Hospital Anxiety and Depression Scale,the Rumination Response Scale,and the Perceived Social Support Scale.Data entry was conducted using Epi Data 3.1,descriptive statistical analysis,univariate and multivariate analysis were performed using SPSS 25.0.Based on the analysis results and findings from previous studies,AMOS 24.0 software was utilized to construct a structural equation model to examine the influencing factors of fear of disease progression in patients with rheumatic diseases.Results:1.A total of 348 patients with rheumatic diseases were included in this study.The total score of fear of disease progression was(29.41±9.46);the score of physical health dimension was(15.48±4.90),and the score of social and family dimension was(73.34±16.52).The high group patients accounted for 28.74%,and the low group patients accounted for 71.26%.2.Univariate factor analysis showed that age,education level, family average monthly income,occupational status,insomnia status and the number of complications had significant effects on the fear of disease progression(P<0.05).The results of correlation analysis showed that fear of disease progression was positively correlated with rumination,fatigue,perceived social support,anxiety and depression;fatigue was positively correlated with rumination,anxiety and depression;rumination was positively correlated with anxiety and depression;there was a negative correlation between perceived social support and depression;anxiety is positively correlated with depression.The results of the multivariate generalized linear regression analysis showed that rumination and anxiety were the influencing factors of the fear of disease progression,and anxiety was the main influencing factor.3.The results of structural equation model analysis showed that rumination had direct and indirect effects on fear of disease progression,and the effect coefficients were 0.265 and 0.250,respectively;The direct effect of anxiety on fear of disease progression was 0.418;Fatigue had indirect effect via rumination on fear of disease progression,and the indirect effect coefficient was-0.209;Depression had indirect effect on fear of disease progression through anxiety,and the indirect effect coefficient was 0.053.R~2=38%,indicating that rumination,anxiety,fatigue and depression explained 38%variation in fear of disease progression.The influencing factors of the fear of disease progression of patients with rheumatic diseases were ranked as rumination,anxiety,fatigue and depression.Conclusion:1.Patients with rheumatic diseases have a high level of fear of disease progression,which deserves the attention of medical staff.2.Rumination,anxiety,fatigue,and depression are influencing factors of fear of disease progression in patients with rheumatic diseases.Among them,rumination has the largest total effect and is the most important factor affecting the fear of disease progression.Reducing the level of rumination in patients has great significance to improve their fear of disease progression...