Abstract: Objective To explore the development trajectory and influencing factors of fear of progression in parents of children with leukemia, and to provide reference for targeted intervention. Methods A prospective longitudinal study was adopted. From October 2022 to July 2023, 187 parents (who met sampling criteria) of children with leukemia were gathered by convenience sampling. Parents were surveyed at the end of one month, three and six months after diagnosis respectively. Latent growth mixture modeling was used to identify trajectory categories of fear of progression. CART algorithm was used to establish a decision tree classification model for the influencing factors. Results Parents’ fear of progression development trajectory was divided into and named as low-level fear rising group（10.0%）, medium-level fear declining group（31.3%）, and high-level fear declining group（58.7%）. Marital status, degree of distress, self-compassion, and cognitive fusion influenced the category of fear of progression trajectory（all P<0.05）. Decision tree classification model analysis showed that cognitive fusion was the root node, while the internal nodes were disease severity, marital status, and self-compassion. Conclusion There are three trajectories of fear of progression in parents of children with leukemia. The decision tree model shows that cognitive fusion is the key influencing factor, followed by disease severity, marital status and self-compassion. Early intervention for fear of progression should be implemented based on possible influencing factors.

Key words: children with leukemia, parents, fear of progression, cognitive fusion, self-compassion, decision tree model