目的 探讨消化系统癌症女性患者希望水平在恐惧疾病进展与生育忧虑间的作用。方法 选取2017年1月—2018年1月本院收治的285例消化系统癌症女性患者作为研究对象,调查其基本情况、希望得分、恐惧疾病进展得分和生育忧虑得分,并建立结构方程模型进行路径分析。结果 消化系统癌症女性患者希望得分为（32.44±4.85）分,恐惧疾病进展得分为（43.53±6.71）分,癌症后生育忧虑得分为（65.42±8.14）分;女性消化系统癌症患者恐惧疾病进展与癌症后生育忧虑呈中度正相关性（r=0.652,P<0.001）,希望与恐惧疾病进展、癌症后生育忧虑均呈中度负相关性（r=-0.535,-0.542,P<0.001）;希望在恐惧疾病进展和癌症后生育忧虑间有部分中介效应（0.143）,占总效应的24.21%。结论 消化系统癌症女性患者恐惧疾病进展水平及生育忧虑感均较高,希望水平相对较低,希望水平能抑制恐惧疾病进展加重生育忧虑效果。

Objective To explore the mediating effect of hope level on fear of disease progression and reproductive anxiety of female digestive cancer patients. Methods A total of 285 female patients with the digestive cancer in our hospital from January 2017 to January 2018 were selected. All participants were investigated with the Chinese version of Herth Hope Scale,the Chinese version of the Fear of Progression Questionnaire-Short Form,the Chinese version of Reproductive Concerns After Cancer Scale. The structural equation model was used to do the route analysis. Results The hope score was（32.44±4.85）,the fear of disease progression score was（43.53±6.71）,and the reproductive anxiety score after cancer was（65.42±8.14） in female patients with digestive system cancer. Pearson’s correlation analysis showed that there was a moderately positive correlation（r=0.652,P<0.001） between the development of fear disease and post cancer reproductive concerns and a moderate negative correlation（r=-0.535,-0.542,P<0.001）between hope and the development of fear disease and post cancer fertility anxiety. Hope has the mediating effect （0.143） between fear of disease progression and post cancer fertility anxiety,accounting for 24.21% of the total effects. Conclusion Fear disease progression and reproductive concerns of female patients with digestive system cancer are higher,and the hope level is relatively low. Hope level can inhibit the progress of fear disease and aggravate the effect of reproductive concerns.