Impact of Symptom Clusters on Fear of Progression in Kidney Transplant Recipients.

Objective: To investigate the association between symptom clusters and fear of progression (FoP) in kidney transplant recipients, and to provide evidence for clinical interventions.

Methods: A cross-sectional study was conducted using convenience sampling, enrolling 209 kidney transplant recipients from a tertiary hospital between September 2024 and January 2025. Participants were assessed using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-62).

Results: The mean total FoP score was 25.15 ± 9.06. Exploratory factor analysis identified 5 symptom clusters, accounting for 72.3% of the total variance. The emotional-related symptom cluster had the highest prevalence (31/209), while patients with neurocognitive symptom clusters reported the highest FoP scores (31.5 ± 9.22). Spearman correlation analysis revealed that FoP was significantly and positively associated with the physical discomfort cluster (r = 0.194), the emotional-related cluster (r = 0.452), and the neurocognitive function cluster (r = 0.255) (P < .001). Multiple regression analysis confirmed that these 3 clusters explained 42.7% of the variance in FoP.

Conclusion: Symptom clusters are closely associated with FoP in kidney transplant recipients. Greater symptom severity is linked to higher levels of FoP. It is recommended that clinicians strengthen symptom cluster management and implement systematic interventions to reduce patients' FoP.