Abstract: Objective: To explore the mediating role of self-management efficacy between fear of progression(FoP), anxiety, and depression among postoperative patients with lung cancer. Methods: With convenience sampling, primary lung cancer patients in a tertiary grade A hospital in Tianjin were selected as the research subjects. The survey was conducted by general information questionnaire, Strategies Used by People to Promote Health (SUPPH), Fear of Progression Questionnaire Short Form (FoP-Q-SF) and Hospital Anxiety and Depression Scale(HADS). Moreover, the mediation model was developed and validated. Results: 320 questionnaires were distributed and 298 questionnaires were collected, with an effective recovery rate of 93.13%. The scores of self-management efficacy, FoP, anxiety and depression among postoperative patients with lung cancer were (97.26 ± 24.36), (28.95 ± 8.75), 6.00(3.00, 8.00) and 4.50(2.00, 7.00), respectively. The patient's anxiety and depression were significantly negatively correlated with self-management efficacy (P<0.001), and were significantly positively correlated with FoP(P<0.001). Self-management efficacy was significantly negatively correlated with FoP (P<0.001). The self-management efficacy of patients after lung cencer surgery had a partial mediation role between FoP and anxiety and depression in postoperative patients with lung cancer. The mediating effect values were 0.024 and 0.033 respectively, accounting for 10.17% and 15.07% of the total effect. Conclusion: Medical staff should pay attention to the psychological state of postoperative patients with lung cancer, and the effective intervention should be carried out to improve their self-management efficacy and reduce the level of FoP, so as to improve patients' negative emotions.

Key words: Lung cancer, Fear of disease progression, Self-management efficacy, Anxiety, Depression, Mediating effect

摘要： 目的：分析肺癌术后患者自我管理效能在恐惧疾病进展与焦虑、抑郁间的中介作用。方法：便利选取天津市某三级甲等医院收治的原发性肺癌患者为研究对象，使用一般资料问卷、癌症自我管理效能感量表、恐惧疾病进展简化量表、医院焦虑抑郁量表对其进行调查，构建并检验中介模型。结果：共发放问卷 320 份，回收有效问卷 298 份，有效回收率 93.13%。肺癌术后患者自我管理效能、恐惧疾病进展、焦虑及抑郁得分依次为（97.26±24.36）分、（28.95±8.75）分、6.00（3.00，8.00）分及 4.50（2.00，7.00）分；患者焦虑、抑郁与自我管理效能均呈负相关（P<0.001），与恐惧疾病进展间呈正相关（P<0.001），自我管理效能与恐惧疾病进展呈负相关（P<0.001）。肺癌术后患者自我管理效能在恐惧疾病进展与焦虑、抑郁间均发挥部分中介作用，中介效应值分别为 0.024 和 0.033，占总效应的 10.17% 和 15.07%。结论：医护人员应关注肺癌术后患者的心理状况，并实施有针对性的护理措施，提升其自我管理效能，降低恐惧疾病进展水平，从而改善患者焦虑、抑郁等负性情绪。

关键词: 肺癌, 恐惧疾病进展, 自我管理效能, 焦虑, 抑郁, 中介效应