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To investigate psychological distress trajectories in surgical lung cancer patients and their influencing factors, and explore the impact of trajectories on quality of life (QoL).
Prospective longitudinal study.
Data from 324 patients at a Chinese tertiary hospital were collected within 48 h of admission (T0), 3 days after surgery (T1), 2 weeks (T2), 3 months (T3), 6 months (T4) and 1 year after discharge (T5). Latent class growth models identified psychological distress trajectories, logistic regression analysed their influencing factors, and linear regression analysed the effects of psychological distress trajectories on QoL.
Psychological distress peaked at T1, then decreased steadily. Three trajectories emerged: low-level stable group (Class 1, 45.06%), intermediate-level decreased group (Class 2, 39.51%) and high-level stable group (Class 3, 15.43%). Compared with Class 1, Class 3 was predicted by surgical modality, lymph node metastasis, postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy, while Class 2 was predicted by surgical modality, postoperative adjuvant therapy and self-efficacy. Furthermore, psychological distress trajectories negatively predicted QoL.
Surgical lung cancer patients experience an initial increase in psychological distress, followed by a gradual decline, with three distinct trajectories. Surgical modality, lymph node metastasis, and postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy were the major influencing factors of psychological distress trajectories. Persistent distress adversely impacts QoL, underscoring the need for early, personalised psychological interventions to improve long-term outcomes.
To explore and analyse the adaptation process of patients and their families at the point of lung cancer diagnosis.
Totally 23 operable lung cancer patients were included in this study. Colaizzi's method of phenomenology was employed for data analysis.
This study found two different aspects of family adaptation at the diagnosis of lung cancer. For family resilience, three themes emerged: (1) Positive family belief systems (giving meaning to a cancer diagnosis and maintaining a positive/optimistic attitude), (2) Flexible family organizational patterns (maintaining the stability of family structure and function, adjusting the relationship between patients and family members and receiving external support and help) and (3) Good communication and problem-solving strategies (open communication on an equal basis, positive and open expression of emotions and collaborative problem-solving). For family vulnerability, three themes were as follows: (1) Negative family belief systems (negative attitudes and concealment and self-isolation due to stigma), (2) Rigid family organizational patterns (adaptation lost, conflicts between family support and patients' willingness and pressure upon social support) and (3) Unhealthy communication and problem-solving (poor communication, emotional asymmetry of family members and tendency to solve problems alone).
The study highlights the existence of the family resilience and family vulnerability at the point of lung cancer diagnosis and provides patient's perspective for understanding family resilience in specific cultural contexts.
The data were collected through face-to-face interviews.
Trail registration number: ChiCTR2300074801.
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