Women with Lung Cancer: Quality of Life after Thoracotomy: A 6-month Prospective Study

Sarna, Linda DNSc, RN, FAAN; Cooley, Mary E. PhD, RN, CS; Brown, Jean K. PhD, RN, FAAN; Chernecky, Cynthia PhD, RN, FAAN; Padilla, Geraldine PhD; Danao, Leda PhD, RN; Chakravarty, Deepalika MS; Elashoff, David PhD

Disclosures

Cancer Nurs. 2010;33(2):85-92. 

In This Article

Abstract and Introduction

Abstract

Background: Data about health-related quality of life (QOL) after surgical treatment for lung cancer are limited. Such information can be valuable in developing appropriate nursing interventions for follow-up care for survivors.
Objectives: The purposes of this study were to describe physical and emotional QOL of disease-free female non-small cell lung cancer (NSCLC) survivors and to determine characteristics associated with greater risk for disruptions.
Methods: One-hundred-nineteen women surgically treated for NSCLC completed the Short-Form 36 (as a measure of physical and mental QOL) along with health status assessments (including comorbidity, depression, Center for Epidemiologic Studies-Depression Scale, smoking status, and body mass index), dyspnea (Dyspnea Index), meaning of illness, and demographic and clinical information at baseline and 3 and 6 months.
Results: On average, the women were 68 years of age, diagnosed 2 years previously, had adenocarcinoma, and were treated surgically with lobectomy. The majority (66%) had comorbid disease, 29% had depressed mood (Center for Epidemiologic Studies-Depression Scale score ≥16), 8% were current smokers, 62% were overweight, 22% had dyspnea (scores ≥2), and 24% had a negative meaning of illness. Physical and emotional QOL scores were comparable to Short-Form 36 norms for older adults and exhibited little change over time. Controlling for time since diagnosis, dyspnea, and depressed mood were strongly related to disruptions in physical and emotional QOL, respectively, across the 6-month study period, with comorbid disease contributing to both models.
Conclusion: Depressed mood, comorbidities, and dyspnea were factors related to poorer physical and emotional QOL. Survivors with these characteristics might benefit from greater supportive care.
Implications for Practice: Screening for dyspnea, depressed mood, and comorbid illness can identify female survivors at-risk for poorer QOL after surgery.

Introduction

Information about health-related quality of life (QOL) of long-term cancer survivors can provide important information to survivors and healthcare providers about issues that require ongoing attention and intervention.[1] Lung cancer deaths of women in the United States are among the highest in the world, and incidence continues to increase.[2] Only 16% of all lung cancers are diagnosed at early-stage disease; the 5-year survival of these patients is approximately 50% to 70%.[3] Surgery is the treatment of choice for patients with potentially curable lung cancer. Comprehensive approaches to supporting recovery after lung cancer surgery include consideration of the patients' perceptions of the impact of their disease and treatment on physical and emotional QOL. Identification of factors that increase risk for disruptions in QOL is important so that those at higher risk can receive appropriate care.[4] The purposes of this study were to describe physical and emotional QOL of female disease-free survivors and to identify factors associated with disruptions in QOL to provide a foundation for future clinical intervention.

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