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- Title
SYMPTOM PATTERNS AFTER THORACOTOMY FOR LUNG CANCER.
- Authors
Sarna, Linda; Cooley, Mary; Brown, Jean K.; Chernecky, Cynthia; Elashoff, David
- Abstract
Research in cancer survivorship is increasing, but there are limited data describing recovery after surgery for lung cancer. The purpose of this paper is to describe symptom patterns and predictors in the first four- months after surgery for non-small-cell lung cancer (NSCLC). The theoretical framework, focused on pain, fatigue, dyspnea, cough, and depression, was based upon the literature and dimensions of the Revised Symptom Management Model. Predictors included person, health status, and clinical variables. Methods: 94 patients were assessed at one (T1), two (T2), and four months (T3) post- thoracotomy. Symptoms were assessed using the Lung Cancer Symptom Scale (LCSS), and the Center for Epidemio-logic Survey-Depression (CES-D, >16 indicating depression). Health status included smoking status, body mass index (BMI), and number of comorbid conditions. Descriptive statistics were used to profile the sample and outcomes. Logistic regression was used to assess clinically meaningful improvement in LCSS symptoms (>10mm change at 4 months). Mixed effects and generalized linear models were used to examine predictors of improvement in symptoms over time. Results: The typical participant was female (58%), aged 63 (SD = 10), had adenocarcinoma (52%), and received a lobectomy (79%). The majority (56%) had >1 comorbid condition, most commonly emphysema (38%). At baseline, 57% were overweight (BMI >25), and 17% smokers. All symptoms except cough significantly improved over time, but clinically important improvement only occurred for appetite (62%) and pain (50%). A minority reported improvements in fatigue (43%) or cough (31%). Those in the "depressed" category (35% at T1 - 26% at T3) significantly declined (OR .29, p = .012). There were multiple co-occurring symptoms at each time. In the regression models, age and number of comorbid diseases were significantly (p <.0001) related to symptom improvement (LCSS total score and individual symptoms), indicating older adults with comorbidity experience greater problems during recovery. Conclusions: Results provide important information for clinical practice. As expected, symptoms continued to improve in the months after thoracotomy. However, fatigue and cough lingered for the majority of patients, and 50% continue to report pain. Older patients and those with comorbid conditions may require additional support in symptom management. Funding Sources: ONS Foundation
- Subjects
CANCER patients; LUNG cancer; PAIN; FATIGUE (Physiology); DYSPNEA; COUGH; MENTAL depression
- Publication
Oncology Nursing Forum, 2007, Vol 34, Issue 1, p185
- ISSN
0190-535X
- Publication type
Article