Latent profile analysis and associated factors of injection-related fear in school-aged children: a cross-sectional investigation

Injection-related fear in school-aged pediatric patients may influence their cooperation with medical procedures and psychological wellbeing. However, few studies have characterized distinct latent profiles of injection-related fear in this pediatric population. To further clarify school-aged pediatric patients’injection-related fear and its latent heterogeneity, this study aimed to identify latent profile classes of injection-related fear in school-aged pediatric patients using latent profile analysis (LPA). Thereafter, potential associated factors of the latent profiles were examined to provide a reference for developing targeted intervention strategies. A cross-sectional investigation was performed between October and December 2025, and 268 school-aged pediatric patients were recruited from the pediatric department at Quzhou People’s Hospital. Participants completed a general information survey instrument, Multidimensional Injection Fear Scale, Chinese Spence Children’s Anxiety Scale (brief version), and Chinese version of the Parent Behavior Inventory. Latent profile analysis (LPA) was used to identify the latent profiles of injection-related fear in school-aged pediatric patients. Predictors of different latent injection-fear profiles were examined using multivariable logistic regression analysis. The Kruskal-Wallis H test was used to compare dimension scores of each latent profile of injection-related fear on the multidimensional fear-of-injection scale among school-aged pediatric patients. The overall injection-related fear score in school-aged pediatric patients was 35.00 (Q1 = 24.00, Q3 = 45.00). Three profiles were identified: the “low fear-cooperative profile” ( n = 99, 36.94%), the “moderate fear-low behavior avoidance profile” ( n = 120, 44.78%), and the “high fear-high physiological response profile” ( n = 49, 18.28%). Multivariable analysis indicated that age of 6–8 years (OR = 3.213, 95% CI: 1.283–8.046), family income level ( OR = 3.158, 95% CI: 1.237–8.060), hostile/coercive parental rearing behavior (OR = 1.084, 95% CI: 1.021–1.150), and child anxiety level (OR = 1.097, 95% CI: 1.051–1.145) were independently associated with injection-fear profile membership. School-aged children exhibit moderate levels of injection-related fear, with evident heterogeneity. Clinical strategies should prioritize early school-aged children (6–8 years) and integrate parental behavior modification, particularly reducing hostile/coercive rearing practices, alongside routine screening and symptom management of child anxiety, to effectively alleviate the ‘high fear–high physiological response’ profile identified in this population.