The relationship between returning to work self-efficacy, anxiety, and depression in renal cancer patients: a cross-lagged analysis

Objectives: This longitudinal study aimed to examine the relationship between return-to-work self-efficacy (RTW-SE), anxiety, and depression in patients with renal cancer. Methods: A total of 282 patients with renal cancer from Sun Yat-sen University Cancer Center were recruited between April and December 2022. Patients were assessed at one month (T1), three months (T2), and six months (T3) after surgery using a general information questionnaire, Return-to-Work Self-Efficacy Scale, Generalized Anxiety Disorder Scale (GAD- 7), and Patient Health Questionnaire (PHQ- 9). Results: RTW-SE progressively increased over time, while anxiety and depression scores showed a decreasing trend. Pearson’s correlation analysis revealed a significant negative association between RTW-SE and both anxiety and depression at all three-time points. Cross-lagged analysis demonstrated that RTW-SE at T1 significantly predicted depression at T2 (β = - 0.066, P < 0.001), whereas RTW-SE at T2 significantly predicted both anxiety (β = - 0.177, P < 0.001) and depression (β = - 0.077, P < 0.001) at T3. Conclusion: Higher RTW-SE scores were associated with lower levels of post-surgery anxiety and depression. These findings highlight the importance of systematic RTW-SE assessments and early interventions to enhance work reintegration and psychological well-being. Incorporating RTW-SE monitoring into postoperative care plans may help to identify high-risk patients and facilitate timely psychological and vocational support. © The Author(s) 2025.