Fear of Progression and Resilience as Mediators of the Association between Family Function and Quality of Life among Patients with Cervical Cancer

Objective. To explore the impact of family function on quality of life (QoL) and investigate the mediating effects of fear of progression (FoP) and resilience in the pathway from family function to QoL among patients with cervical cancer (CC). Methods. A multicenter cross-sectional survey with convenience sampling was conducted from December 2021 to December 2022. A total of 252 patients with cervical cancer were recruited from five tertiary hospitals in Jiangsu Province, China. Patients completed the 5-item self-administered Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) scale, the Fear of Progress Questionnaire short-form, the 14-item Resilience Scale, and the 12-item Short-Form Health Survey. Structural equation modeling (SEM) was performed to explore the mediation effect of FoP and resilience between family function and QoL for CC patients. Bootstrapping procedures were used to verify the significance of the indirect effects of the mediating variables. Results. The mean score of family function was 7.97 +/- 2.41 (scale range: 0-10), FoP was 29.58 +/- 10.14 (scale range: 12-60), and resilience was 69.37 +/- 14.36 (scale range: 14-98). The mean score for physical component summary (PCS) was 41.87 +/- 10.00 (scale range: 0-100), and the mean score for mental component summary (MCS) was 46.68 +/- 11.78 (scale range: 0-100). Family function positively predicted patients' resilience and negatively predicted their FoP, while FoP negatively predicted CC patients' resilience and QoL, and resilience positively predicted patients' QoL. Patients' family function was associated with their QoL directly and indirectly through the mediation of FoP and resilience, and the model explained 7% of the variation in FoP, 24% of the variation in resilience, and 42% of the variation in QoL. Conclusions. Chinese CC patients expressed poor QoL. FoP and resilience could mediate the association between patients' family function and QoL. Healthcare professionals could improve QoL of patients with cervical cancer through reducing FoP and enhancing resilience.