Xinping Shi,1 Yuexia Wang,1 Qisen Jia,2 Shengwei Peng,1,* Xing Liu,1,* Yongju Pei1 

1Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China; 2Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yongju Pei, Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, Zhengzhou, Henan, People’s Republic of China, Email de738822@163.com

Purpose: The low follow-up compliance of young and middle-aged patients with newly diagnosed pulmonary nodules warrants attention, primarily due to a series of factors such as occupational, familial, and social pressures. Enhancing follow-up adherence is essential for preventing pulmonary nodule progression and reducing lung cancer mortality. Existing research indicates that intolerance of uncertainty is closely associated with patients’ follow-up compliance; however, further in-depth investigation into its influencing mechanisms and potential improvement strategies is required.
Patients and Methods: This study conducted a questionnaire survey among 319 young and middle-aged patients newly diagnosed with pulmonary nodules, examining the moderating effect of self-compassion on follow-up compliance and investigating the chain intermediary role of negative interpretation bias and trust in linking intolerance of uncertainty to follow-up compliance.
Results: The study found that women, urban residents, and patients over 50 years old demonstrated relatively higher follow-up compliance. Intolerance of uncertainty was found to negatively predict follow-up compliance and indirectly influenced patients’ follow-up behavior through the mediating effects of negative interpretation bias and trust. Furthermore, self-compassion significantly moderated the relationship between trust and follow-up compliance.
Conclusion: The findings provide a solid theoretical foundation for developing multidimensional interventions targeting both protective and risk factors. Specifically, mitigating the impact of intolerance of uncertainty on follow-up compliance can improve long-term patient health outcomes. The novel application of the chain mediation model provides valuable insights for future research and clinical practice, particularly in enhancing patient engagement and adherence to follow-up care. Future longitudinal studies are needed to explore additional influencing factors and validate these findings.

Keywords: IU, interpretation bias, trust, self-compassion, initial diagnosis of pulmonary nodules, compliance