Factors Influencing Fear of Progression in Endometriosis: A Path Analysis Using the Common-Sense Model

Purpose: This study aims to explore the factors that may contribute to fear of progression in women with endometriosis and reveal the relationship among social support, illness perception, coping strategies and fear of progression. Patients and Methods: This single-center cross-sectional study collected information from 273 women with endometriosis between August 2024 and February 2025 using the Social Support Rating Scale, the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, and the Fear of Progression Questionnaire-Short Form. Descriptive statistics and Pearson correlation analysis were performed on the data using SPSS 25.0, and path analysis was performed using AMOS 24.0 to examine the direct and indirect effects between variables. Results: The analysis showed that the total score of fear of progression in 273 patients with endometriosis was 30.95 ± 8.15 (range: 12– 60). The mediation effect analysis revealed that social support had a direct effect on fear of progression (effect = − 0.176; 95% CI, − 0.331 to − 0.024) and influenced fear of progression through three mediating pathways: (i) the sole mediating effect of illness perception (effect = − 0.268; 95% CI, − 0.412 to − 0.153), (ii) the sole mediating effect of avoidance (effect = − 0.054; 95% CI, − 0.112 to − 0.003), (iii) the chained mediating effect of illness perception on avoidance (effect = − 0.052; 95% CI, − 0.087 to − 0.024). Conclusion: This study demonstrated that women with endometriosis experienced a moderate to high levels of fear of progression. The findings underscore the chain mediating effects of illness perception and avoidance in the relationship between social support and fear of progression. Healthcare providers should implement targeted interventions focusing on social support and maladaptive coping, with particular emphasis on addressing negative illness perception, to reduce patients’ fear of progression. Keywords: endometriosis, fear of progression, common sense model, social support, illness perception, coping strategies, path analysis