Factors associated with the fear of disease progression in older spousal caregivers of patients with cancer: a cross-sectional study

Aim To describe the fear of disease progression levelin the older spousal caregivers of patients with cancer in China and explore factors associated with the fear of disease progression and the complex relationships among these factors. Background The older spousal caregivers of patients with cancer might have a high level of fear of disease progression, which is greater than that perceived by patients. However, there is a lack of attention given to the influencing factors of fear of disease progression among older spousal caregivers of patients with cancer. Design This study followed a cross-sectional design. Methods: A total of 210 older spousal caregivers of patients with cancer were eligible to complete the general sociodemographic and disease questionnaire, the Chinese version of the Fear of Disease Progression Questionnaire-Short-Form for Partners, Form C of the Multidimensional Health Locus of Control Scale, the Family Avoidance of Communication about Cancer Scale, and the Brief Health Literacy Assessment. The data were analyzed via univariate analysis, Pearson correlation analysis, multiple linear regression analysis, structural equation modeling, and a bootstrap mediation effect test. Results The older spousal caregivers of patients with cancer had high total scores for fear of disease progression (35.21±9.79). Powerful-other health locus of control and health literacy were significantly negatively correlated with fear of disease progression, respectively(P<0.01), whereas family avoidance of communication about cancer was significantly positively correlated with fear of disease progression (P<0.01). Moreover, family avoidance of communication about cancer and health literacy had a chain mediating effect between powerful-other health locus of control and fear of disease progression. Conclusions Fear of disease progression among older spousal caregivers of patients with cancer can be reduced by the use of nursing strategies to control available sources, especially the powerful-other health locus of control, encouraging family communication about cancer, and improving health literacy.