The mediating role of medical coping modes between anxiety and fear of progression in patients with cervical intraepithelial neoplasia grade 3: a cross-sectional survey
Fear of progression (FOP) is a significant psychological burden among patients with cervical intraepithelial neoplasia grade 3 (CIN3) and negatively impacts their mental health and quality of life. This study aimed to explore the mediating role of medical coping modes in the relationship between anxiety and FOP in these patients. This cross-sectional study included 168 patients with CIN3 from a university hospital in Nantong, China. The participants completed the FOP questionnaire, the self-rating anxiety (SAS) scale, and the medical coping modes questionnaire (MCMQ). Structural equation modeling (SEM) was used to analyze the mediating effects of medical coping modes (confrontation, avoidance, and resignation) on the relationship between anxiety and FOP. This study conducted an in-depth questionnaire survey and analysis of 168 patients with grade 3 CIN. The results revealed elevated scores on both the SAS and FOP scale, with 58.3% of patients exhibiting clinically significant FOP scores. With respect to medical coping styles, correlation analysis revealed that anxiety was significantly positively correlated with avoidance, resignation coping styles, and FOP scores (P < 0.05). Univariate analysis revealed trends toward significant differences in FOP scores based on disease duration and family history of cervical cancer. Multivariate logistic regression further confirmed that anxiety level (SAS) (OR = 1.11), avoidance coping (OR = 1.17), and resignation coping (OR = 1.26) were independent predictors of FOP (P < 0.05). Stratified analysis reinforced the stable associations between these predictors and FOP across different disease characteristics. The results of the mediation analysis revealed that resignation coping partially mediated the relationship between anxiety and FOP, whereas avoidance coping had no significant mediating effect. Finally, structural equation modeling validated the indirect pathway through which anxiety influences FOP through resignation coping. Anxiety, avoidance, and resignation coping are significant predictors of FOP in patients with CIN3. Resignation coping plays a crucial mediating role in the relationship between anxiety and FOP. These findings suggest that targeted interventions addressing resignation coping may help reduce FOP and improve psychological well-being in these patients. Future research should explore longitudinal designs and culturally tailored interventions to further understand and mitigate FOP in this population.