Changes and Related Factors of Quality of Life in Newly Diagnosed Lung Cancer Patients Receiving Treatment

• Main Authors: Yu-Chien Liao, 廖幼媫
• Other Authors: 賴裕和
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/38fukh

博士 === 國立臺灣大學 === 護理學研究所 === 99 === Newly diagnosed lung cancer patients experience severe physical and psychological impacts during their first three-month treatment. Ineffective adaptation during this period will negatively affect their long-term quality of life (QOL). Little was known about the factors related to the change of QOL of patients with stage III - IV lung cancer in this critical period. Therefore, the purposes of this study were to examine the levels and change of QOL, symptoms, self-efficacy on cancer coping behavior and symptom management, uncertainty and depression in newly diagnosed lung cancer patients undergoing first three-month treatment, and to determine the related factors of the change of QOL in six dimensions (global QOL, physical function, role function, psychological function, cognitive function and social function). The prospective longitudinal study of 74 newly diagnosed lung cancer patients at a medical center in northern Taiwan assessed their symptoms, QOL, self-efficacy on cancer coping behavior, symptom management self-efficacy, uncertainty and depression at pretreatment and one-month and three-month after treatment initiated. Six Generalized Estimating Equations (GEE) models were applied to analyze the longitudinal data and to identify the significantly related factors of change of QOL in six dimensions. The results showed that the participants had a moderate level of global QOL which did not change statistically in the period of study. Relatively low scores in role function and social function were reported. Physical, cognitive and role functions significantly reduced over time while emotional and social functions had no significant change. In general, levels of symptoms were mild-to-moderate; cough and hemoptysis significantly diminished after treatment while the other symptoms increased or remained unchanged. Stable self-efficacy and reduced uncertainty were observed over time while depression increased with 31.3 % of the participants developing clinical depression after the three-month treatment. The GEE models identified that self-efficacy on coping behavior, fatigue, pain and treatment significantly contributed to the change of global QOL. Demographic and disease characteristics, symptoms, self-efficacy on coping behavior, uncertainty and depression significantly affected the change of different dimensions of QOL-related functioning. In conclusion, the QOL of newly diagnosed lung cancer patients was affected by multiple factors. A comprehensive multi-faceted intervention delivered by a multi-disciplinary team consisting of systematic assessment of QOL and the related factors, tailored symptom management and training of symptom management skills, self-efficacy enhancement, and uncertainty reduction is suggested to improve patients’ QOL. Further research to test the feasibility and effectiveness of the QOL enhancement intervention is recommended.