Disease Impact and Unmet Needs in Postoperative Early Stage Lung Cancer Patients

• Main Authors: Yaun-Ju Lin, 林晏汝
• Other Authors: 賴裕和
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/39836859311682636411

碩士 === 國立臺灣大學 === 護理學研究所 === 105 === Background and purpose Lung cancer patients often experience great impact and many unmet supportive care needs during the course of the disease and during treatment. However, the current status of the experience of patients with early lung cancer is limited. Therefore, the main objectives of this study are: (1) to explore the symptoms and functional status, impact of disease and care needs of patients with early lung cancer at three months after surgery; (2) to analyze the related factors of care needs, including demographic characteristics, disease treatment characteristics (stage, operation type, histological form of cancer), physical function (symptom severity, performance status) and impact of disease (intrusion, avoidance, hyperarousal). Method and materials This is a cross-sectional study conducted in a medical center in Northern Taiwan. This study focused on (1) symptom severity, (2) performance status, (3) impact of disease, (4) care needs, and (5) demographic information and disease characteristics of early stage lung cancer patients. Those variables that we wanted to explore were assessed by (1) The European Organization for Research and Treatment of Cancer QLQ-C30 and Lung Cancer module (EORTC QLQ-C30; LC 13); (2) Karnofosky performance scale (KPS); (3) Impact of Event Scale-Revised (IES-R); (4) Supportive care needs survey-screening tool 9 (SCNS-ST9); and (5) Background and Disease / Treatment Information Form (BDIF). The results of the collection were analyzed by using descriptive statistics, Spearman&apos;&apos;s correlation, and regression models. In this study, the sample size was estimated by G-power F test statistic, and 108 patients with early stage (I-IIIA) lung cancer were estimated recruited. Results The results of study showed that early stage lung cancer patients after surgery experienced mild symptom severity with top five severe symptoms as cough, insomnia, fatigue, pain in other parts and dyspnea. The level of impact of disease which patients experienced was also mild and the levels of IES-R sub-dimensions as their descending order were avoidance, intrusion and hyperarousal, respectively. According to the results, in general, patients had low to moderate levels of care needs, ranking as their mean score as "Health System and Information Needs", "Psychological Needs", "Patient Care and Support Needs", "Physical and Daily Living Needs" and "Sexual Needs", while the most care needs are " To be informed about things you can do to help yourself get well." Patients’ overall care needs were associated to symptom severity ( r=0.43, p<0.01)、physical function (r=-0.23, p<0.05), overall impact of disease (r = 0.49, p <0.01), intrusion (r = 0.43, p <0.01), avoidance ( r=0.36, p<0.01) and hyper-arousal (r = 0.55, p <0.01), and further explore the predictive factors by using the Logistic regression analysis, cancer staging, histological types of cancer, symptom severity, and hyper-arousal were predictive factors of care needs. Conclusion Although patients with early stage lung cancer have a longer survival period compared with advanced cancer, they may still have several symptoms and perceive impact of disease during follow-up period. We need to pay attention in particular on the patient with higher avoidance and hyper-arousal symptoms to prevent them from the difficulties of emotional healing and high levels of unmet care needs. In addition, we need to strengthen the planning of information on the disease and treatment in order to give appropriate assistance to patients with early stage lung cancer and to reduce the unmet needs of health system and information for improving the quality of care.