Fear of disease progression in primary caregivers of children with malignant solid tumors: a latent profile analysis

The primary caregivers of children with malignant solid tumors often experience a high level of fear regarding the progression of the disease. This condition not only impairs caregivers’ mental health but may also compromise children’s treatment adherence and family functioning. This study aimed to identify distinct latent classes of FoP among these caregivers and to explore associated factors, thereby informing the development of targeted psychological interventions. Using convenience sampling, this study enrolled 303 primary caregivers of children with solid tumors treated at a tertiary hospital in Zhejiang Province between July 2025 and February 2026. Data were collected using a general information questionnaire, the Fear of Progression Questionnaire for Parents, the Brief Coping Style Questionnaire, the General Self-Efficacy Scale, and the Social Support Rating Scale. Latent profile analysis was employed to identify latent classes of FoP, and univariate analysis followed by multinomial logistic regression was conducted to examine factors associated with class membership. This study, through a survey of the primary caregivers of 303 children with solid tumors, found that the overall score of FoP-Q-SF/PR was 38.09 ± 8.29. Among them, 213 caregivers (accounting for 70.3%) had a score reaching or exceeding the clinical critical value (≥ 34 points). Further latent profile analysis identified three potential categories: low progression fear group (27.4%, n = 83), moderate progression fear group (36.3%, n = 110), and high progression fear group (36.3%, n = 110). Multinomial logistic regression analysis showed that Female caregivers (OR = 2.177 ~ 2.233), low income (OR = 2.597), and negative coping strategies (OR = 1.093 ~ 1.151) were significantly associated with the risk of FoP (all P < 0.05); while positive coping strategies (OR = 0.927 ~ 0.935, P < 0.05), self-efficacy (OR = 0.921, P < 0.05), and social support (OR = 0.919, P < 0.05) had significant protective effects on FoP. There is significant heterogeneity in the level of fear of disease progression among primary caregivers of children with solid tumors. It is noteworthy that female caregivers, caregivers from low-income families, individuals with poor coping styles, low self-efficacy, and insufficient social support are at higher risk of elevated FoP levels. It is necessary to develop targeted preventive measures and psychological intervention programs for these modifiable factors to reduce FoP levels and improve the mental health of caregivers.