Fear of progression in Chinese patients after cardiac valve replacement: profiles, influencing factors, and mechanisms.

Aims: This study aims to investigate the latent profiles and influencing factors of fear of progression (FoP) among patients following cardiac valve replacement (CVR) and to explore the mechanisms of FoP and its primary influencing factors.

Methods And Results: This cross-sectional study included 385 patients who had undergone CVR in Hunan Province, China. Data on FoP, Type D personality, death anxiety, medical coping modes, and family function were collected using appropriate questionnaires. A serial multiple mediation model was utilized to evaluate the multiple effects of family function on FoP. The average FoP score of the patients following CVR was 35.59 ± 8.21, with 191 exhibiting high FoP levels. Family function negatively affected resignation coping mode (β = -0.255, P < 0.001), death anxiety (β = -0.145, P < 0.001), and FoP (β = -0.363, P < 0.001). Resignation coping mode and death anxiety demonstrated a chain mediating role (β = -0.036, P < 0.001) between family function and FoP, accounting for 13.84% of the total indirect effect. Latent profile analysis identified four FoP profiles: a 'low-risk fear group' (8.05%), 'moderate-risk fear group' (42.33%), 'high-risk fear group' (34.54%), and 'severe-risk fear group' (15.06%). Patients with high levels of death anxiety, Type D personality, monthly household income <3000 RMB, and adoption of avoidance or resignation coping modes (all P < 0.05) were more likely to be classified into the 'Severe fear group.'

Conclusion: Patients who have undergone CVR exhibit heterogeneous profiles, with 49.60% showing high and severe FoP. Family members and clinical staff should focus on patients with a high risk of FoP and provide targeted prevention strategies and psychological care according to the characteristics and influencing factors of distinct FoP profiles.