Abstract: Objective: To investigate the chain-mediating effects of family cohesion and self-disclosure in the relationship between hope levels and Fear of Progression (FoP) among patients with gynecologic malignancies, providing a reference for reducing patients' FoP. Methods: From October to December 2024, a convenience sampling method was employed to recruit 255 inpatients with gynecologic malignancies from four tertiary grade A hospitals in Haikou. Data were collected using the General Information Questionnaire, the short form of the Fear of Progression Questionnaire, the Herth Hope Index, the Family Cohesion Scale, and the Distress Disclosure Index. The chain-mediating effects of family cohesion and self-disclosure between hope level and FoP were analyzed using AMOS 24.0 software. Results: The mean scores for FoP, hope level, family cohesion, and self-disclosure among patients with gynecologic malignancies were 32.07±9.82, 35.80±5.36, 58.60±6.80, and 38.58±5.80, respectively. Hope level had a direct predictive effect on FoP, contributing 57.94% of the total effect. It indirectly influenced FoP through family cohesion and self-disclosure, as well as their chain-mediating effects, with the indirect effects accounting for 24.60%, 13.02%, and 4.44% of the total effect, respectively. Conclusion: Hope level not only exerts a direct influence on FoP in patients with gynecologic malignancies, but also indirectly affects it through the mediating roles of family cohesion and self-disclosure.

Key words: gynecologic malignancy; Fear of Progression; hope level; family cohesion; self-disclosure