Quality of life and related factors in patients with newly diagnosed advanced lung cancer: a longitudinal study

PURPOSE/
OBJECTIVES: To examine the changes in quality of life (QOL), symptoms, self-efficacy for coping with cancer, and factors related to those changes in patients with newly diagnosed advanced lung cancer.
DESIGN: Longitudinal and correlational.
SETTING: Oncology inpatient wards and outpatient departments of a medical center in northern Taiwan. SAMPLE: 101 patients newly diagnosed with stage IIIB or IV lung cancer.
METHODS: Questionnaires were used to assess patients' QOL, symptoms, and self-efficacy before treatment and at one and three months following treatment. Factors related to the changes in global QOL and five functional dimensions were analyzed using six generalized estimating equation models. MAIN RESEARCH VARIABLES: QOL, symptoms, and self-efficacy for coping with cancer.
FINDINGS: Patients reported moderate levels of global QOL, symptom severity, and self-efficacy for coping with cancer. They also reported high physical and cognitive functions, but relatively low role and social functions. Factors were significantly related to the most functional dimensions, including self-efficacy, fatigue, pain, sleep difficulties, and demographic- and disease-related factors. Self-efficacy was the most robust factor for predicting QOL.
CONCLUSIONS: Patients with advanced lung cancer experience a compromised global QOL and relatively low social and role functioning during the first three months following cancer diagnosis. Levels of self-efficacy and symptoms significantly affected changes in QOL and functioning. IMPLICATIONS FOR NURSING: Applying a systematic assessment of changes in QOL and developing comprehensive interventions with self-efficacy training and symptom management are strongly recommended for clinical care to improve the QOL of patients with advanced lung cancer.