Objective:

To examine whether psychological resilience and psychological distress serially mediate the association between fear of disease progression and quality of life (QoL) in patients with chronic heart failure (CHF).

Key Findings:

• Mean scores: FoP-Q = 43.60, CD-RISC = 52.71, DASS-21 = 44.29, MLHFQ = 48.63 (all p < 0.05).
• FoP negatively correlated with psychological resilience (r = −0.775) and positively correlated with psychological distress (r = 0.868) and MLHFQ scores (r = 0.773).
• Psychological resilience negatively correlated with psychological distress (r = −0.728) and MLHFQ scores (r = −0.744).
• Psychological distress positively correlated with MLHFQ scores (r = 0.745).
• Mediation model showed direct effect of FoP on QoL (effect = 0.629, 41.14%) and three indirect pathways.

Interpretation:

Psychological resilience and psychological distress are significant serial mediators in the relationship between fear of disease progression and quality of life in CHF patients.

Limitations:

• Single-center study may limit generalizability.
• Cross-sectional design does not allow for causal inferences.

Conclusion:

Patients with CHF exhibited elevated levels of fear of progression and reduced quality of life, with psychological factors playing a mediating role.