Latent Profiles of Fear of Complications and Associated Factors Among Older Inpatients with Type 2 Diabetes: A Cross-Sectional Study.

Aim: In the context of diabetes, fear of complications (FoC) refers to a psychological response to the anticipated onset or progression of diabetes-related chronic complications. However, analyses based solely on total scores may conceal the heterogeneity among patients. This study aimed to identify latent FoC profiles among older inpatients with type 2 diabetes mellitus (T2DM) and examine the demographic and clinical characteristics, hope, and self-management factors associated with these profile.

Methods: In this cross-sectional study, 310 older inpatients with T2DM were recruited from the endocrinology department of a tertiary hospital between January and October 2024, and 299 valid questionnaires were analyzed. Data were collected through face-to-face interviews using a general information questionnaire, the Fear of Complications Questionnaire (FCQ), the Adult Dispositional Hope Scale (ADHS), and the Summary of Diabetes Self-Care Activities (SDSCA). Latent profile analysis was conducted in Mplus 8.3, group comparisons and hierarchical multinomial logistic regression were performed using SPSS 26.0.

Results: Three profiles were identified: low FoC (36.8%), moderate FoC (43.8%), and high FoC (19.4%). Compared with the low FoC profile, higher hope scores, higher self-management scores, and absence of complications, were associated with lower odds of membership in both moderate FoC profile (ORs = 0.867, 0.955, and 0.390 respectively; all P < 0.01) and high FoC profile (ORs = 0.694, 0.811, and 0.194 respectively; all P < 0.05).

Conclusion: A person-centered analysis identified three profiles characterized by increasing levels of FoC among older inpatients with T2DM. Higher-FoC profiles were associated with greater complication burden, lower hope, and lower self-management capacity, suggesting that FoC assessment may benefit from integrating clinical characteristics with psychological and behavioral factors. External replication and prospective validation are needed before these profiles can be applied to bedside classification or profile-matched interventions.