A Psychometric Network Analysis of Fear of Progression, Coping Styles, and Self-Management Among Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Background Continuous ambulatory peritoneal dialysis (CAPD) requires patients to perform complex self-management tasks at home. Fear of progression and coping styles may influence self-management, but their dimension-level relationships remain poorly understood. Objective To investigate the network structure linking fear of progression, coping styles, and self-management among CAPD patients and identify central and bridging dimensions that may be relevant for nursing assessment and intervention planning. Methods A cross-sectional study was conducted among 328 CAPD patients in a tertiary hospital in Sichuan, China. Fear of progression, coping styles, and CAPD self-management were assessed using validated questionnaires. A psychometric network was estimated at the dimension level, and centrality, bridge centrality, and network stability were evaluated. Results The strongest edge was observed between physical health-related and social/family-related fear of progression (edge weight = 0.663). Confrontation coping exhibited the highest strength and expected influence and showed the strongest cross-community connectivity, with bridge strength and bridge expected influence z-scores of 2.57 and 2.60, respectively. The strongest cross-community edge was identified between confrontation coping and diet management (edge weight = 0.264). Centrality and bridge centrality analyses demonstrated acceptable-to-good stability. Conclusion Confrontation coping emerged as a central and bridging d
Abstract
Background Continuous ambulatory peritoneal dialysis (CAPD) requires patients to perform complex self-management tasks at home. Fear of progression and coping styles may influence self-management, but their dimension-level relationships remain poorly understood. Objective To investigate the network structure linking fear of progression, coping styles, and self-management among CAPD patients and identify central and bridging dimensions that may be relevant for nursing assessment and intervention planning. Methods A cross-sectional study was conducted among 328 CAPD patients in a tertiary hospital in Sichuan, China. Fear of progression, coping styles, and CAPD self-management were assessed using validated questionnaires. A psychometric network was estimated at the dimension level, and centrality, bridge centrality, and network stability were evaluated. Results The strongest edge was observed between physical health-related and social/family-related fear of progression (edge weight = 0.663). Confrontation coping exhibited the highest strength and expected influence and showed the strongest cross-community connectivity, with bridge strength and bridge expected influence z-scores of 2.57 and 2.60, respectively. The strongest cross-community edge was identified between confrontation coping and diet management (edge weight = 0.264). Centrality and bridge centrality analyses demonstrated acceptable-to-good stability. Conclusion Confrontation coping emerged as a central and bridging dimension linking psychological responses and self-management behaviours in CAPD patients. These findings reflect statistical connectivity rather than causal relationships and may help identify priorities for nursing assessment and future intervention research.