目的 通过质性与量性研究方法探讨主动控制感对护理本科生(以下简称“护生”)实习焦虑影响的机制。方法 采用便利抽样法，选取2024年9—10月河北省4所医学院校，在三级甲等医院实习的护生为研究对象。量性研究部分采用中文版主动控制感量表(Chinese sense of agency scale,C-SoAS)、广泛性焦虑量表(generalized anxiety disorder 7-item scale,GAD-7)、医院关怀氛围感知量表进行调查，质性研究部分采用半结构深入访谈法进行调查。结果 本研究共收到有效问卷592份，共收集17名护生访谈资料。结果显示，护生主动控制感总分为(43.73±9.14)分、广泛焦虑总分为3.00(1.00,7.00)分、医院关怀氛围感知总分为(251.38±39.93)分。多元线性回归分析结果显示，与外科实习比较，在手术室实习和医院关怀氛围感知是护生实习焦虑得分的影响因素。医院关怀氛围感知与主动控制感得分呈正相关(r=0.426,P<0.05)，与实习焦虑得分呈负相关(r=-0.341,P<0.05)，主动控制感得分与实习焦虑得分呈负相关(r=-0.484,P<0.05)。主动控制感在医院关怀氛围感知和实习焦虑间起中介作用，中介效应占总效应的39.94%。访谈资料提炼出3个主题，分别是：与护生学习期望不一致；感受实习中关怀氛围；实践能力不足。结论 护生实习焦虑水平差异较大，主动控制感起到中介作用，护生的主动控制感是动态变化的，提升护生主动控制感可以缓解实习焦虑，提示医院管理者关注影响护生主动控制感的因素，维护护生身心健康。

Objective To explore the mechanisms of sense of agency on the anxiety of nursing students(hereinafter referred to as "nursing students") during internships by qualitative and quantitative research methods. Methods Using the convenient sampling method, undergraduate nursing students who interned in tertiary hospitals from 4 medical schools in Hebei province from September to October 2024 were selected as the research objects.The quantitative study was investigated by using the Chinese sense of agency scale(C-SoAS), the generalized anxiety disorder 7-item scale(GAD-7), and the hospital care atmosphere perception scale, and the qualitative study was investigated by semi-structured in-depth interview method.Results A total of 592 valid questionnaires were received in this study, and interviews with 17 undergraduate nursing students were collected. The results showed that the total score of sense of agency was(43.73±9.14) points, the total score of generalized anxiety was 3.00(1.00,7.00) points, and the total score of hospital care atmosphere perception was(251.38±39.93) points.The multiple linear regression analysis revealed that, compared to surgical internships, operating room internships and perceived hospital care atmosphere were factors influencing the anxiety scores of nursing students during their internships.The perception of hospital care atmosphere was positively correlated with the score of sense of agency(r=0.426, P<0.01), negatively correlated with the score of internship anxiety(r=-0.341, P<0.01), and the score of sense of agency was negatively correlated with the score of internship anxiety(r=-0.484, P<0.01). The sense of agency played a mediating role between the perception of hospital care atmosphere and internship anxiety, and the mediating effect accounted for 39.94% of the total effect. The interview materials were distilled into 3 themes, namely: inconsistency with nursing students' learning expectations; feel the caring factors in the internship; and insufficient practical ability.Conclusion Nursing students exhibit significant variation in their levels of internship-related anxiety, the sense of agency plays a mediating role, and the sense of agency of nursing students is dynamic and changes over time, and promotion of the sense of agency of nursing students can alleviate their internship anxiety.It is suggested that hospital managers should pay attention to the factors affecting the sense of agency of undergraduate nursing students and maintain their physical and mental health.