Fear of progression and associated factors in glaucoma patients: a latent profile analysis

Fear of progression (FoP) is patients' fear of the illness progression or exacerbation and occurs in numerous chronic diseases, leading to poor quality of life. Glaucoma patients, who suffer from chronic and progressive visual impairment, are at high risk of developing fears such as falling or blindness. However, FoP has received limited attention in glaucoma population. This study aimed to identify patterns of FoP in glaucoma patients and explore the relationship between FoP, glaucoma symptoms, illness perception, as well as socio-demographic and clinical factors, thereby improving personalized health care in glaucoma patients.

Convenience sampling method was used to select glaucoma patients. A sample of 227 glaucoma patients completed relevant questionnaires, which included sections on the socio-demographic and clinical information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Glaucoma Symptom Scale Questionnaire and the Brief Illness Perception Questionnaire. Latent profile analysis was performed using the scores from the 12 items of the FoP-Q-SF, while univariate and ordinal logistic regression analyses were used for statistical evaluation.

Three FoP groups were identified: low FoP-supported group (21.14%), moderate FoP-stable group (47.58%), and high FoP-uncertain group (31.28%). Middle age (OR = 2.971, 95% CI = 1.071-8.240), unemployment (OR = 2.560, 95% CI = 1.203-5.441), being married (OR = 2.342, 95% CI = 1.053-5.202), a worse VF MD in their worse eye (OR = 0.969, 95% CI = 0.942-0.996) and higher levels of illness perception (OR = 1.040, 95% CI = 1.011-1.069) were more likely to experience higher FoP.

The findings emphasize the importance of identifying distinct FoP profiles in glaucoma patients, particularly among those in the high FoP group. Factors such as middle age, unemployment, being married, more severe visual field damage, and perceived illness burden are closely linked to higher FoP levels. Healthcare providers can implement more tailored interventions that address the psychological needs of glaucoma patients, ultimately reducing their FoP.