Factors associated with fear of disease progression among older spousal caregivers of cancer patients: a cross-sectional study

To describe the lever of fear of disease progression among older spousal caregivers of cancer patients in China and to explore the associated factors and their interrelationships. Older spousal caregivers of cancer patients may experience a high level of fear of disease progression, potentially exceeding that experienced by the patients themselves. However, limited attention has been given to the factors influencing this fear in this specific population. A cross-sectional study design was employed. A total of 210 older spousal caregivers of cancer patients completed a general sociodemographic and disease questionnaire, the Chinese version of the Fear of Disease Progression Questionnaire-Short-Form for Partners, Form C of the Multidimensional Health Locus of Control Scale, the Family Avoidance of Communication About Cancer Scale, and the Brief Health Literacy Assessment. Data were analyzed using univariate analysis, Pearson correlation analysis, multiple linear regression, structural equation modeling, and bootstrap mediation analysis. Older spousal caregivers of cancer patients reported high levels of fear of disease progression (35.21 ± 9.79). Powerful-others health locus of control and health literacy were both weak negatively correlated with fear of disease progression (P < 0.01), whereas family avoidance of communication about cancer showed a positive correlation (P < 0.01). Moreover, family avoidance of communication about cancer and health literacy acted as parallel mediators between powerful-others health locus of control and fear of disease progression. Fear of disease progression among older spousal caregivers of cancer patients can be alleviated through nursing interventions that enhance communication between them and medical staff, promote open family communication about cancer, and improve their health literacy through multimodal approaches.