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

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.