Metacognitive status and latent profile analysis of health anxiety among patients undergoing maintenance hemodialysis

Background Health anxiety is a prevalent mental health concern among patients undergoing maintenance hemodialysis (MHD), significantly impacting their psychological well-being and quality of life. Metacognition—individuals' awareness and regulation of their own cognitive processes—plays a critical role in shaping the experience and severity of health anxiety. However, few studies have explored the heterogeneous latent profiles of metacognition related to health anxiety in the MHD population, and the factors influencing these profiles remain unclear. Identifying distinct metacognitive profiles and their associated factors is essential for developing targeted psychological interventions to alleviate health anxiety in this vulnerable group. Methods A cross-sectional study was conducted using a convenience sampling method. From November 2024 to February 2025, a total of 390 MHD patients were recruited from a tertiary grade A hospital in Chengdu, China. Data were collected using two validated instruments: a general demographic questionnaire (capturing variables such as occupation, employment status, and comorbidities) and the Metacognition Questionnaire for Health Anxiety (MQ-HA). Latent Profile Analysis (LPA) was performed to identify distinct subgroups of patients based on their metacognitive features related to health anxiety. Univariate analysis was first used to screen potential influencing factors, followed by multivariate Logistic regression analysis to determine the independent factors associated with the identified latent profiles. Statistical significance was set at P  < 0.05. Results LPA revealed two distinct latent profiles of metacognition related to health anxiety among MHD patients:"Healthy Cognition Stable Profile": Accounting for 36.3% of the sample, this group exhibited adaptive metacognitive patterns, including low overconcern about health-related thoughts and effective regulation of health-related cognition."Health Anxiety Distorted Profile": Representing 63.7% of the sample, this group showed maladaptive metacognitive characteristics, such as excessive rumination on health threats, difficulty controlling health-related worries, and negative beliefs about health-related thoughts. Multivariate Logistic regression analysis indicated that occupation ( P  < 0.05), employment status ( P  < 0.05), and presence of comorbidities ( P  < 0.05) were independent influencing factors of the latent profiles of metacognition related to health anxiety. Conclusions Metacognition related to health anxiety in MHD patients exhibits significant heterogeneity, with two distinct latent profiles identified. Healthcare providers should tailor psychological counseling and targeted interventions based on the key influencing factors (occupation, employment status, and comorbidities) of each profile. Such personalized approaches are crucial for effectively reducing health anxiety levels, improving psychological well-being, and enhancing the quality of life of MHD patients.