Prevalence and associated factors of fear of progression in patients with heart failure in China: a scoping review
TL;DR
It is found that FoP is relatively common in patients with HF in China and is associated with a range of factors, which may support early identification of high-risk patients and the development of integrated psychological and social care strategies in HF management.
Abstract
Introduction Heart failure (HF) is a complex, multifactorial clinical syndrome with an increasing global prevalence and high rates of rehospitalization and mortality. Fear of progression (FoP) is a common psychological concern among patients with chronic diseases, such as cancer and diabetes. Given the progressive nature of HF, FoP may represent an equally important psychological concern in this population. It is associated with poor treatment adherence, reduced quality of life, and a higher risk of adverse cardiovascular events and unplanned hospital readmissions. However, studies specifically investigating FoP in patients with HF remain relatively limited, and the existing evidence has not yet been systematically synthesized. This scoping review aimed to map the assessment tools, prevalence, and associated factors of FoP among Chinese patients with HF. Methods This scoping review was reported following the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Relevant studies were searched in ten databases, including PubMed, Web of Science Core Collection, Scopus, Embase, CINAHL, CNKI, Wanfang, VIP, CBM, and CMA Journals Full-text Database, from database inception to December 31, 2025. The Joanna Briggs Institute (JBI) Critical Appraisal Checklists were used to assess the quality of included studies. Results This scoping review identified 2,875 records, and 17 studies from China were finally included. These studies included 3,918 patients with HF, and the prevalence of FoP ranged from 23.40% to 48.00%. Twenty-nine associated factors were identified and grouped into four categories: sociodemographic factors, disease and treatment factors, psychological and cognitive factors, and health and functional factors. Conclusion This scoping review found that FoP is relatively common in patients with HF in China and is associated with a range of factors. These findings may support early identification of high-risk patients and the development of integrated psychological and social care strategies in HF management. Future research should focus on developing assessment tools specific to HF, understanding how FoP changes over time, identifying effective interventions, and validating these findings across diverse geographical populations.