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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Psychopathology

This article is part of the Research TopicInnovations in Psychological Care for Oncology and Palliative Settings: A Holistic ApproachView all 21 articles

The impact of illness perception on quality of life in lung cancer chemotherapy patients: mediating effect of fear of progression

Provisionally accepted
Fan  XuFan XuShaoju  XieShaoju XieQiao  LiQiao LiXiaoli  ZhongXiaoli Zhong*Jiquan  ZhangJiquan Zhang*
  • People’s Hospital of Deyang City, Deyang, China

The final, formatted version of the article will be published soon.

Background: Quality of life (QoL) in lung cancer chemotherapy patients has been a key concern for researchers, and there are no studies examining the relationship between illness perception(IP), fear of progression(FoP), and QoL in lung cancer chemotherapy patients. This remains an understudied topic. Objective: Exploring the mediating effect of FoP between IP and QoL in lung cancer chemotherapy patients. Methods: From January to June 2024, 390 lung cancer chemotherapy patients were recruited through convenience sampling from the outpatient clinics and inpatient wards of the Department of Oncology at a tertiary Grade-A hospital in Deyang, China. Participants completed a battery of instruments comprising a general information questionnaire, the Brief Illness Perception Questionnaire (BIPQ), the Fear of Progression Questionnaire–Short Form (FoP-Q-SF), and the Functional Assessment of Cancer Therapy–Lung (FACT-L). Data were analyzed with SPSS 26.0 to examine associations among IP, FoP, and QoL. The mediating role of FoP in the relationship between IP and QoL was tested with the PROCESS 4.1 macro. Results: Total IP score (44.71±9.47), FoP score (39.35±6.79), and total QoL score (66.43±23.67) in lung cancer chemotherapy patients; Pearson's correlation analysis showed that IP was negatively correlated with QoL (r=-0.401, P<0.001) and positively correlated with FoP (r=0.363, P<0.001); FoP was negatively correlated with QoL (r=-0.319, P<0.001); Mediation analysis revealed that FoP partially mediated the relationship between IP and QoL, accounting for 18.5 % of the total effect (indirect effect = -0.065, 95 % CI [-0.107, -0.027]). Conclusion: Lung cancer chemotherapy patients' IP can directly affect the QoL, and can also indirectly affect the QoL through FoP. Therefore, in clinical practice, we should focus on the IP and FoP of lung cancer chemotherapy patients, and provide effective psychological guidance and clinical intervention when necessary, while medical institutions can take some targeted measures to improve the negative emotions and psychological cognition of patients and improve the QoL.

Keywords: lung cancer, illness perception, Quality of Life, Fear of progression, mediation effect

Received: 10 Oct 2025; Accepted: 10 Nov 2025.

Copyright: © 2025 Xu, Xie, Li, Zhong and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Xiaoli Zhong, 1061035879@qq.com
Jiquan Zhang, dyzhangjiquan@163.com

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