Objective:To investigate the role of cognitive appraisal and benefit-finding in the association be-tween fear of progression and quality of life among patients with chronic heart failure.Methods:A total of 362 chronic heart failure(CHF)patients from two tertiary hospitals were assessed with the Fear of Progression Ques-tionnaire-Short Form(FoP-Q-SF),Cognitive Appraisal of Health Scale(CAHS),Benefit-Finding Scale(BFS),and Minnesota Living with Heart Failure Questionnaire(MLHFQ).Results:The MLHFQ total scores were positively correlated with the scores of FoP-Q-SF and CAHS(r=0.57,0.44,Ps＜0.01),and negatively correlated with the BFS scores(r=0.47,P＜0.01).Structural equation modeling revealed that cognitive appraisal and benefit-finding sequentially mediated the relationship between fear of progression and quality of life,accounting for 27.43％of the total indirect effect.Conclusion:The psychological adaptation of chronic heart failure patients follows a negative chain path of"fear→maladaptive cognition→ meaning deprivation".while the synergistic intervention of cognitive reappraisal and benefit-finding could disrupt this cascade.Interventions combining cognitive reappraisal and benefit-finding may interrupt this process and improve quality of life.

Objective:To investigate the role of cognitive appraisal and benefit-finding in the association be-tween fear of progression and quality of life among patients with chronic heart failure.Methods:A total of 362 chronic heart failure(CHF)patients from two tertiary hospitals were assessed with the Fear of Progression Ques-tionnaire-Short Form(FoP-Q-SF),Cognitive Appraisal of Health Scale(CAHS),Benefit-Finding Scale(BFS),and Minnesota Living with Heart Failure Questionnaire(MLHFQ).Results:The MLHFQ total scores were positively correlated with the scores of FoP-Q-SF and CAHS(r=0.57,0.44,Ps＜0.01),and negatively correlated with the BFS scores(r=0.47,P＜0.01).Structural equation modeling revealed that cognitive appraisal and benefit-finding sequentially mediated the relationship between fear of progression and quality of life,accounting for 27.43％of the total indirect effect.Conclusion:The psychological adaptation of chronic heart failure patients follows a negative chain path of"fear→maladaptive cognition→ meaning deprivation".while the synergistic intervention of cognitive reappraisal and benefit-finding could disrupt this cascade.Interventions combining cognitive reappraisal and benefit-finding may interrupt this process and improve quality of life.