Trajectories and predictors of psycho-social adjustment in patients post hepatocellular carcinoma surgery: A longitudinal study.

BACKGROUND

Patients post hepatocellular carcinoma (HCC) surgery encounter physiological challenges as well as psychological and social adaptation problems，yet the trajectory and predictors of their psychosocial adjustment (PSA) remain underexplored.

METHODS

This prospective longitudinal study utilized convenience sampling to recruit 190 patients with primary HCC who underwent initial surgery at a tertiary hospital in Xi'an between December 2023 and May 2024. Data were collected at one week, two, four, and six months after surgery. Measures included psychosocial adjustment, fear of progression (FoP), resilience, and social support. Analyses included latent class growth modeling to identify PSA trajectories and cross-lagged panel modeling to examine temporal relationships between PSA and FoP.

RESULTS

A total of 159 patients completed all four surveys. PSA in patients post HCC surgery generally exhibited a trend of initial increase followed by a decline.The latent class growth analysis identified three PSA trajectories: low-level fluctuation, low-level ascending, and low-level persistent. Compared to the low-level persistent group, social support, T3 FoP, and T4 FoP predicted PSA's shift to the low-level ascending group (P < 0.05), while T3 FoP predicted its shift to the low-level fluctuation group (P < 0.05). The cross-lagged panel model indicated that PSA significantly and negatively predicted FoP across time, whereas FoP did not predict PSA over time.

CONCLUSION

Patients post HCC surgery exhibit a dynamic trajectory of PSA within six months.Strengthening social support and reducing FoP may steer PSA toward ascending or fluctuating paths. Early PSA elevation helps lower subsequent FoP, creating a positive cycle that continually enhances patients' mental health.