目的：探讨肺癌初治患者心理痛苦相关因素，为肺癌患者心理康复提供科学依据。方法： 采用横断面调查的研究方法，对2013年6月至2015年3月期间住院治疗的肺癌初治患者进行问卷调查，调查问卷包括3部分：一般资料调查问卷、综合医院焦虑抑郁量表（hospital anxiety and depression scale，HADS）、心理痛苦管理筛查工具（distress management screening measure，DMSM）,了解肺癌初治患者的心理痛苦现状，分析影响心理痛苦评分的相关因素。结果： 共调查了390位肺癌初治患者，其中男性291例（74.6%）、女性99例（25.4%）。焦虑阳性症状（HADS焦虑评分≥9分）患者占26.7%（104/390），抑郁阳性症状（HADS抑郁评分≥9分）患者占27.7%（108/390），心理痛苦的阳性率（痛苦温度计评分≥4分）为30%（117/390），DMSM中的问题列表里排在前5位的分别是担忧、疾病治疗、呼吸、疼痛和睡眠。Spearman相关分析显示，患者的心理痛苦评分与焦虑评分、抑郁评分、焦虑抑郁总体评分均呈正相关（P＜0.001）。多元线性回归分析得出，性别（β=-0.209，P=0.003）、年龄（β=-0.098，P=0.042）、是否合并慢性病（β=0.378，P<0.001）、疼痛评分（β=0.100，P=0.029）对心理痛苦评分有影响；吸烟（β=0.111，P=0.041）对患者的焦虑情绪有影响。结论： 肺癌初治患者的性别、年龄、是否合并慢性病、疼痛评分是心理痛苦评分的独立影响因素，而吸烟是患者焦虑情绪的预测因素。积极控制疼痛和慢性病的临床进展，解决睡眠和呼吸相关问题，帮助患者有计划、循序渐进的戒烟，都将有利于缓解患者的心理痛苦。

Objective：To study the impact factors of psychological distress in patients with first diagnosed lung cancer. Methods: The cross-sectional study was applied to newly diagnosed lung cancer patients who received treatments in Cancer Center of West China Hospital of Sichuan University in Chengdu from June 2013 to March 2015 by distributed questionnaires. The general information of the patients, the hospital anxiety and depression scale (HADS) and distress management screening measure (DMSM) were included in the questionnaire to evaluate the states of distress, pain and the factors related to the distress of the patients. Results: The survey investigated a total of 390 patients with first diagnosed lung cancer, including 291 male patients and 99 female patients. The proportion of the patients with positive anxiety symptom was 26.7% (104/390), with positive depression symptom was 27.7% (108/390), and with positive distress symptom was 30.0% (117/390). On the top five problem list of DMSM were worry, disease treatment, breathing, pain and sleep. The Spearman correlation analysis showed that an-xiety score, depression score, and the pain intensity were positively correlated with the distress. Multiple linear regression analysis showed that gender (β=-0.209, P=0.003), age (β=-0.098, P=0.042), chronic disease (β=0.378, P<0.001), and pain score (β=0.100, P=0.029) could affect the distress of the patients. Smoking (β=0.111, P=0.041) could affect the anxiety of newly diagnosed lung cancer patients. Conclusion: The gender, age, chronic disease and pain score of the patients are the independent factors of the psychological distress of first diagnosed lung cancer patients. Smoking is the predictive factors of the patients with anxiety. Controlling the pain intensity and the clinical process of chronic disease of the patients actively, solving the sleep and breathing problem and helping the patients to quit smoking progressively could alleviate the psychological distress of the patients.