Fear of disease progression and its associated factors in patients with acute pancreatitis: a cross-sectional study

Abstract Objective To assess the level of fear of disease progression (FoP) in patients with acute pancreatitis (AP) during early hospitalization and identify its influencing factors. Methods This cross-sectional study was conducted from March 2024 to June 2025 at a tertiary hospital in Xiamen, China. A total of 212 AP patients were recruited via convenience sampling. On the second day of admission, FoP was measured using the AP-FoP-Q-SF scale. Demographic, clinical, psychological, and self-reported symptom variables were also collected. Statistical analyses included descriptive statistics, chi-square or Mann–Whitney U tests, and multivariable binary logistic regression to identify factors associated with moderate-to-severe FoP (total score > 26). Results The prevalence of moderate-to-severe FoP was high at 59.4%, with a mean AP-FoP-Q-SF score of 26.78 ± 6.12. Item-level analysis showed that fears related to being a burden to family and disease worsening or recurrence were the most prominent concerns. Multivariable logistic regression analysis demonstrated that heavy financial burden (OR = 9.29, 95% CI: 2.65–32.66), alcohol use history (OR = 2.07, 95% CI: 1.07–4.02), and greater subjective weakness (OR = 1.21 per 1-point increase, 95% CI: 1.10–1.33) were associated with increased odds of moderate-to-severe FoP. Compared with patients aged 18–44 years, those aged 45–59 years had significantly lower odds of moderate-to-severe FoP (OR = 0.29, 95% CI: 0.14–0.59). Higher perceived social support was independently associated with reduced odds of moderate-to-severe FoP (OR = 0.97 per 1-point increase, 95% CI: 0.94–0.995). Conclusion A substantial proportion of patients experience clinically significant FoP at the onset of hospitalization for AP, with fears centered on familial burden and disease progression. Our cross-sectional analysis identified several factors independently associated with FoP, including socioeconomic strain, health behaviors, physical symptoms, and lower levels of social support. Early screening for FoP—which could prioritize younger patients, those with financial strain, alcohol use, lower social support, or pronounced weakness—may therefore be beneficial to facilitate timely psychosocial interventions.