Jo A Dalton1, Melinda K Higgins, Andrew H Miller, Francis J Keefe, Fadlo R Khuri. 1. *Nell Hodgson Woodruff School of Nursing Departments of †Psychiatry §Hematology and Medical Oncology, School of Medicine, Winship Cancer Institute, Emory University, Atlanta, GA ‡Department of Psychiatry, Division of Behavioral Medicine, Duke University Medical Center, Durham, NC.
Abstract
OBJECTIVE: To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset. MATERIALS AND METHODS: A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10 mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated. RESULTS: Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final. CONCLUSIONS: Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.
OBJECTIVE: To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset. MATERIALS AND METHODS: A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10 mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated. RESULTS: Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final. CONCLUSIONS: Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.
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