The status of fear of disease progression and the construction of psychological dysfunction prediction model in postoperative patients with lung cancer

Wu Zhengnan; Wang Mingming; Zhao Ronghua; Ren Shuwen; Li Titi; Zhan Bicheng

doi:10.3969/j.issn.1674-3245.2025.02.017

Abstract：Objective To investigate the status of fear of disease progression in patients with lung cancer after surgery,analyze the influencing factors of psychological dysfunction,and construct a prediction model.Methods The convenience sampling method was used to prospectively select 385 patients who underwent lung cancer surgery in our hospital from January 2023 to January 2024 as a training set for research.The patients were investigated by general data questionnaire,fear of disease progression scale(FoP-Q-SF),self-rating anxiety scale(SAS)and self-rating depression scale(SDS).According to the FoP-Q-SF score,the patients were divided into psychological dysfunction group(≥34 points)and non-psychological dysfunction group(＜34 points).Univariate analysis and multivariate logistic regression analysis were used to analyze the related factors of psychological dysfunction,and a prediction model was constructed.The area under the receiver operating characteristic(ROC)curve(AUC)and Hosmer-Lemeshow(H-L)were used to verify the prediction effect of the model.According to the ratio of 3∶7 to the training set,165 patients who underwent lung cancer surgery in our hospital from February 2024 to July 2024 were selected for external verification.Results The FoP-Q-SF score of 385 patients with lung cancer after operation in the training set was(34.51±6.24)points,of which the physical health dimension score was(18.27±4.26)points,and the social family dimension score was(16.24±3.87)points.There were 177 cases in the psychological dysfunction group,and the incidence rate was 45.97％.Multivariate Logistic regression analysis showed that female,low education level,low family average monthly income,no spouse,high SAS score,high SDS score,and tumor stage Ⅲ～Ⅳ were risk factors for psychological dysfunction in patients with lung cancer after surgery.The H-L test results of the training set showed that x2=2.810,P=0.946,the AUC of the prediction model was0.887(95％ CI=0.855～0.919,P＜0.001),the sensitivity was 0.797,and the specificity was 0.846.The H-L test results of the validation set showed that x2=4.858,P=0.711,the AUC of the prediction model was 0.892(95％CI=0.859～0.925,P＜0.05),the sensitivity was 0.808,and the specificity was 0.880.Conclusion The level of fear of disease progression in patients after lung cancer surgery is high.The prediction model based on the seven risk factors in the results has good predictive efficacy,which can effectively provide reference for clinical intervention and reduce the occurrence of psychological dysfunction in patients after lung cancer surgery.