International Journal of General Medicine (Jul 2025)
Fear of Disease Progression in Patients with Type 2 Diabetes Construction and Validation of a Nomogram Prediction Model
Abstract
Xiaoxiao Liu,1,2 Junjun Wang,3 Haili Dong,2 Yanmin Zhao,4 Li Liu1 1Medical Insurance Department, Binzhou Medical University Hospital, Binzhou, Shandong, 256600, People’s Republic of China; 2College of Nursing, Binzhou Medical University, Binzhou, Shandong, 256600, People’s Republic of China; 3Blood Donation Service Department, Binzhou Central Blood Station, Binzhou, Shandong, 256600, People’s Republic of China; 4Endocrinology Department, Binzhou Medical University Hospital, Binzhou, Shandong, 256600, People’s Republic of ChinaCorrespondence: Li Liu, Medical Insurance Department, Binzhou Medical University Hospital, No. 661, Huanghe 2nd Road, Bincheng District, Binzhou, Shandong, 256600, People’s Republic of China, Tel +86 13854336002, Email [email protected]: This study aimed to understand the current situation of phobia regarding disease progression in patients with type 2 diabetes mellitus (T2DM) and identify its influencing factors.Methods: A convenient sampling method was used to select patients with T2DM who were hospitalized in a tertiary A hospital in Binzhou City, Shandong Province, from September 2024 to February 2025 as the research objects. The evaluation tools included a general information questionnaire, a simple disease perception questionnaire, a chronic disease health literacy scale, a diabetes self-management behavior scale, a family resilience scale, and a simplified scale for fear of disease progression. Factors influencing the fear of disease progression in patients with T2DM were analyzed through single-factor and binary logistic regression analyses.Results: Among 346 patients with T2DM, 124 patients exhibited fear of disease progression, with an incidence of 35.80%. Multifactor logistic regression analysis indicated that gender, place of residence, number of complications, scores on the Brief Illness Perception Questionnaire, and Family Resilience Assessment Scale were independent risk factors for fear of disease progression. Using these risk factors, a nomogram prediction model was constructed that achieved an area under the receiver operating characteristic curve of 0.814 (0.767– 0.862), with a sensitivity and specificity of 76.6%. The maximum Youden index and the optimal cutoff value were determined to be 0.532 and 0.361, respectively. Internal validation results using the Bootstrap self-sampling method indicated that the calibration curve of the nomogram closely approximated the ideal curve.Conclusion: The incidence of fear of disease progression (FOP) is higher in patients with T2DM. The constructed risk prediction model has good predictive performance and can provide a reference for assessing the risk of FOP in patients with T2DM. Simultaneously, it is conducive to the formulation of intervention strategies targeting risk factors.Keywords: type 2 diabetes, fear of disease progression, influencing factors, psychological resilience
