Abstract
OBJECTIVE: To explore psychological distress and its influencing factors, including hope, rumination, and fear of disease progression, among spouses of patients diagnosed with familial clustering of hepatitis B virus (HBV) -related hepatocellular carcinoma (HCC). METHODS: A cross-sectional design was adopted. Using convenience sampling method, 218 spouses of patients with familial clustering of HCC were recruited between March 2024 and April 2025 in a tertiary cancer hospital, Tianjin, China. Survey questionnaires included the Psychological Distress Thermometer, Herth Hope Scale, Rumination Scale, and Fear of Progression Questionnaire. Hierarchical multiple linear regression was used to test the influencing factors of psychological distress. RESULTS: Psychological distress was prevalent among spouses, with 51.80% reporting severe to extreme levels. Psychological distress showed a negative correlation with hope (r = -0.162) and positive correlations with rumination (r = 0.380) and fear of disease progression (r = 0.528). Those spouses with the presence of children with HBV, three or more relatives diagnosed with HCC, and partial understanding of the patient's health condition were more psychologically distressed. Hierarchical multiple linear regression revealed that the presence of a child with HBV, three or more relatives diagnosed with HCC, partial understanding of the patient's health condition, and fear of disease progression were significant predictors of psychological distress (P < 0.05). However, hope and rumination did not remain significant predictors after controlling for fear of disease progression (P > 0.05). CONCLUSIONS: Spouses of patients with familial clustering of HCC experience notably high levels of psychological distress. Fear of disease progression, past family losses, the anticipated cancer risk for their children, and the demands of caregiving contribute to a significant level of psychological burden. It is critical to provide targeted clinical interventions to address their fear of disease progression, which may serve as a key factor in alleviating their psychological distress.