The relationships among symptom experience, family support, health literacy, and fear of progression in advanced lung cancer patients

J Adv Nurs. 2023 Sep;79(9):3549-3558. doi: 10.1111/jan.15692. Epub 2023 May 4.

Abstract

Aims: Fear of progression of cancer patients can affect their psychological well-being, while research on fear of progression of advanced lung cancer patients is limited. This study aimed to describe fear of progression among advanced lung cancer patients and explore the relationships among symptom experience, family support, health literacy, and fear of progression.

Design: This study was a cross-sectional study.

Methods: Convenience sampling was used to select advanced lung cancer patients from September 2021 to January 2022. The Chinese version of the Fear of Progression Questionnaire-Short Form, Lung Cancer Module of the MD Anderson Symptom Inventory, Family Support Questionnaire, and Health Literacy Scale for Patients with Chronic Disease were used to collect data. The structural equation modelling was used to analyse the relationships among symptom experience, family support, health literacy, and fear of progression.

Results: Of 220 patients, 31.8% had dysfunctional fear of progression. Better symptom experience, higher family support, and higher health literacy were correlated directly with lower fear of progression. Higher health literacy was associated indirectly with lower fear of progression through the mediation of better symptom experience.

Conclusion: Fear of progression among advanced lung cancer patients needs attention. Strengthening symptom management, building a strong system of family support, and improving patients' health literacy may be effective strategies to reduce fear of progression.

Impact: The research aimed to increase our understanding of the relationships among symptom experience, family support, health literacy, and fear of progression. Fear of progression screening should be integrated into the healthcare trajectory of advanced lung cancer patients. The results emphasize that improving symptom management, family support, and health literacy is important to alleviate fear of progression. Further interventions are warranted to relieve fear of progression for advanced lung cancer patients.

Patient or public contribution: No public or patient involvement.

Keywords: family support; fear of progression; health literacy; lung cancer; structural equation modelling; symptom experience.

MeSH terms

  • Cross-Sectional Studies
  • Family Support
  • Fear / psychology
  • Health Literacy*
  • Humans
  • Lung Neoplasms* / psychology
  • Surveys and Questionnaires