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Psychol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy of a multi-component intervention based on the Situational, Affective, Bodily, and Cognitive (SABC) stress-response model in reducing psychological distress and enhancing quality of life among post-thoracoscopic lung-cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single-center, assessor-masked, parallel-group randomized controlled trial, 240 patients were randomized (1:1) to either a 12-month SABC intervention (<jats:italic>n<\/jats:italic> = 120) or standard care (<jats:italic>n<\/jats:italic> = 120) by means of computer-generated, sealed-envelope allocation. Outcome assessors were blinded to group assignment. The intervention comprised psycho-education, SABC-based skills training, a daily-habits checklist and scheduled follow-up. Psychological distress was measured with the NCCN Distress Thermometer (DT); quality of life was assessed with the EORTC QLQ-C30 at baseline and at 1, 3, 6, and 12 months post-surgery. Linear mixed-effects models were used, under both intention-to-treat (ITT) and per-protocol analyses, to test time-by-group interactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Time-by-group interactions favored the intervention group for physical (ITT: <jats:italic>F<\/jats:italic> = 5.632, <jats:italic>P<\/jats:italic> &amp;lt; 0.001; PP: <jats:italic>F<\/jats:italic> = 6.084, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), role (ITT: <jats:italic>F<\/jats:italic> = 3.325, <jats:italic>P<\/jats:italic> = 0.010; PP: <jats:italic>F<\/jats:italic> = 2.675, <jats:italic>P<\/jats:italic> = 0.031) and emotional functioning (ITT: <jats:italic>F<\/jats:italic> = 5.543, <jats:italic>P<\/jats:italic> &amp;lt; 0.001; PP: <jats:italic>F<\/jats:italic> = 5.566, <jats:italic>P<\/jats:italic> &amp;lt; 0.001), and for the distress thermometer (ITT: <jats:italic>F<\/jats:italic> = 3.791, <jats:italic>P<\/jats:italic> = 0.005; PP: <jats:italic>F<\/jats:italic> = 5.258, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). Social functioning improved in the ITT analysis only (<jats:italic>P<\/jats:italic> = 0.016); fatigue improved in the per-protocol analysis only (<jats:italic>P<\/jats:italic> = 0.008). No significant differences were observed for cognitive functioning, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhea, financial difficulties or global health status (<jats:italic>P<\/jats:italic> &amp;gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A structured SABC-informed intervention significantly improves functional domains and reduces psychological distress in early-stage lung-cancer survivors after thoracoscopic surgery. Limitations include recruitment from a single tertiary center and exclusion of patients with severe comorbidities, which may limit generalisability to broader clinical populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>A randomized controlled trial of a psychological-distress intervention in patients with lung cancer based on the SABC framework. 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