Mick van de Wiel1, Sofie Derijcke2, Daniella Galdermans3, Marc Daenen4, Veerle Surmont5, Els De Droogh3, Anneke Lefebure6, Erika Saenen7, Elke Vandenbroucke8, Ann-Marie Morel9, Anna Sadowska10, Jan P van Meerbeeck11, Annelies Janssens11. 1. University Hospital Antwerp, Department of Thoracic Oncology, Edegem, Belgium. Electronic address: mick.vandewiel@uza.be. 2. Department of Pulmonology-Thoracic Oncology, AZ Groeninge, Kortrijk, Belgium. 3. Department of Pulmonology-Thoracic Oncology, ZNA Middelheim, Antwerp, Belgium. 4. Department of Pulmonology, Ziekenhuis Oost Limburg, Genk, Belgium. 5. Department of Pulmonology-Thoracic Oncology, Ghent University, Ghent, Belgium. 6. Department of Pulmonology-Thoracic Oncology, ZNA STER, Antwerp, Belgium. 7. Lung diseases/Allergology, AZ Heilige Familie, Reet, Belgium. 8. Department of Pulmonology-Thoracic Oncology, AZ Monica, Antwerp, Belgium. 9. Department of Pulmonology, Sint-Jozefkliniek Bornem & Willebroek, Bornem, Belgium. 10. Department of Pulmonology, Ziekenhuis Maas en Kempen, Campus Maaseik, Maaseik, Belgium. 11. University Hospital Antwerp, Department of Thoracic Oncology, Edegem, Belgium.
Abstract
INTRODUCTION: Patients with advanced lung cancer experience high physical symptom burden with substantial psychological distress. Depressive and anxiety symptoms are common and associated with worse quality of life (QoL). Early palliative care (EPC) addresses the complex supportive care needs improving QoL and mood. The mechanisms of EPC are uncertain. We examined whether and how coping strategy, a primary component of EPC, influenced QoL in these patients. MATERIALS AND METHODS: We conducted a multicenter cross-sectional study of patients with advanced lung cancer. A total of 125 patients completed assessments of QoL (QLQ-C15-PAL), depressive and anxiety symptoms (HADS), and coping (brief COPE questionnaire). The data were analyzed by descriptive statistics. To determine whether and how coping strategy influences QoL, correlations and logistic regressions were performed. RESULTS: Positive reframing correlates significantly with global QoL (r = 0.25, P < .01), emotional well-being (r = 0.33, P < .01), pain (r = -0.30, P < .01), fatigue (r = -0.22, P < .01), loss of appetite (r = -0.22, P < .01) and nausea (r = -0.24, P < .01). Self-blame correlates significantly with worse emotional well-being (r = -0.19, P < .05) and insomnia (r = 0.19, P < .05). Using a 4-step logistic regression model, it was found that anxiety and depressive symptoms fully mediated the relationship between positive reframing and QoL. CONCLUSIONS: Patients with advanced lung cancer using positive reframing as coping strategy, experience higher QoL. The mechanism behind it seems that positive reframing goes along with less anxiety and depressive symptoms leading to a better QoL. Self-blame leads to more insomnia and worse emotional well-being. Providing skills to cope effectively could impact QoL in these patients.
INTRODUCTION: Patients with advanced lung cancer experience high physical symptom burden with substantial psychological distress. Depressive and anxiety symptoms are common and associated with worse quality of life (QoL). Early palliative care (EPC) addresses the complex supportive care needs improving QoL and mood. The mechanisms of EPC are uncertain. We examined whether and how coping strategy, a primary component of EPC, influenced QoL in these patients. MATERIALS AND METHODS: We conducted a multicenter cross-sectional study of patients with advanced lung cancer. A total of 125 patients completed assessments of QoL (QLQ-C15-PAL), depressive and anxiety symptoms (HADS), and coping (brief COPE questionnaire). The data were analyzed by descriptive statistics. To determine whether and how coping strategy influences QoL, correlations and logistic regressions were performed. RESULTS: Positive reframing correlates significantly with global QoL (r = 0.25, P < .01), emotional well-being (r = 0.33, P < .01), pain (r = -0.30, P < .01), fatigue (r = -0.22, P < .01), loss of appetite (r = -0.22, P < .01) and nausea (r = -0.24, P < .01). Self-blame correlates significantly with worse emotional well-being (r = -0.19, P < .05) and insomnia (r = 0.19, P < .05). Using a 4-step logistic regression model, it was found that anxiety and depressive symptoms fully mediated the relationship between positive reframing and QoL. CONCLUSIONS: Patients with advanced lung cancer using positive reframing as coping strategy, experience higher QoL. The mechanism behind it seems that positive reframing goes along with less anxiety and depressive symptoms leading to a better QoL. Self-blame leads to more insomnia and worse emotional well-being. Providing skills to cope effectively could impact QoL in these patients.
Authors: Hermioni L Amonoo; Monica H Bodd; Matthew J Reynolds; Ashley M Nelson; Richard Newcomb; Patrick Connor Johnson; Tejaswini M Dhawale; Rachel Plotke; Lauren Heuer; Sabah Gillani; Daniel Yang; Emma C Deary; Elizabeth Daskalakis; Lauren Goldschen; Andrew Brunner; Amir T Fathi; Thomas W LeBlanc; Areej El-Jawahri Journal: Blood Adv Date: 2022-04-12