The mediating effect of dyadic coping between illness perception and fear of disease progression in bladder cancer patients: A cross-sectional survey

This study examines determinants of fear of disease progression (FoP) in bladder cancer patients and test dyadic coping (DC) as a mediator between illness perception (IP) and FoP. In this cross-sectional study, 126 bladder cancer patients underwent comprehensive assessment using a general information questionnaire, a fear of disease progression questionnaire-short form (FoP-Q-SF), a brief IP questionnaire and a DC inventory. Structural equation modeling with bootstrap resampling (n = 5000 iterations) quantified DC's mediating role in the IP-FoP pathway. The scores for IP, DC, and FoP in patients with bladder cancer were (37.73 ± 12.28), (125.18 ± 23.51), and (31.18 ± 9.46), respectively. Differences in the level of fear of disease progression across gender, age, literacy, income level, time of diagnosis, whether or not they relapsed, and the number of relapses were statistically significant (all P < .05). Mediation analysis demonstrated that DC functioned as a significant partial mediator in the IP-FoP relationship (indirect effect β = 0.328, 95% CI [0.227-0.452]), accounting for 59.6% of the total effect. IP exerts both direct effects on FoP and indirect effects mediated through DC. Consequently, clinicians should implement evidence-based dyadic interventions to mitigate cancer recurrence anxiety and enhance quality of life.