Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T07:46:10.004Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental adjustment after surgery for non-small cell lung cancer

Published online by Cambridge University Press:  29 April 2003

YOSUKE UCHITOMI ,
TATSUO AKECHI ,
MAIKO FUJIMORI ,
MASAKO OKAMURA  and
AKIRA OOBA
YOSUKE UCHITOMI
Affiliation:
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
TATSUO AKECHI
Affiliation:
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
MAIKO FUJIMORI
Affiliation:
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan
MASAKO OKAMURA
Affiliation:
Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
AKIRA OOBA
Affiliation:
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Although surgery for early-stage non-small cell lung cancer (NSCLC) is generally considered curative, the outcome is still unsatisfactory, leaving patients faced with uncertainty and fear of recurrence for a long time after surgery. The purpose of this study was to clarify the course of patients' mental adjustment after surgery for NSCLC and to identify predictors of long-term outcome.

Methods: A total of 205 patients completed a baseline interview for patient characteristics at 1 month after curative resection of NSCLC and for social support at 3 months, and the Mental Adjustment to Cancer scale at 3 and 12 months. Univariate and multivariate analyses were used to identify predictors of their psychological outcome.

Results: The helplessness/hopelessness subscale score improved slightly after curative resection (p < .001), but the score on the fighting spirit subscale score was unchanged (p = .659). Significant predictors of helplessness/hopelessness at 12 months included helplessness/hopelessness at 3 months and advanced disease stage, and satisfaction with confidants. Significant predictors of fighting spirit at 12 months included fighting spirit at 3 months existence of confidants.

Significance of results: The results suggested that mental adjustment improved slightly after curative resection for NSCLC. They also suggested the need to maintain continuity of psychosocial care that provides social support, and that an approach that includes careful attention to patients with advanced stage disease may be a strategy for improving mental adjustment after surgery for NSCLC.

Keywords

Non-small cell lung cancerMental adjustmentHelplessness/hopelessnessFighting spiritDepressionSurgerySocial support
Type
Research Article
Information
Palliative & Supportive Care , Volume 1 , Issue 1 , March 2003 , pp. 61 - 70
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Akechi, T., Fukue-Saeki, M., Kugaya, A., Okamura, H., Nishiwaki, Y., Yamawaki, S., & Uchitomi, Y. (2000). Psychometric properties of the Japanese version of the Mental Adjustment to Cancer (MAC) scale. Psycho-Oncology, 9, 395–401.3.0.CO;2-O>CrossRefGoogle Scholar
Akechi, T., Kugaya, A., Okamura, H., Nishiwaki, Y., Yamawaki, S., & Uchitomi, Y. (1998a). Predictive factors for psychological distress of ambulatory lung cancer patients. Supportive Care in Cancer, 6, 281–286.Google Scholar
Akechi, T., Okamura, H., Yamawaki, S., & Uchitomi, Y. (1998b). Predictors of patients' mental adjustment to cancer: Patient characteristics and social support. British Journal of Cancer, 77, 2381–2385.Google Scholar
American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., Revised. Washington, DC: American Psychiatric Press.
Ayres, A., Hoon, P.W., Franzoni, J.B., Matheny, K.B., Cotanch, P.H., & Takayanagi, S. (1994). Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients. Journal of Psychosomatic Research, 38, 393–402.CrossRefGoogle Scholar
Bernhard, J. & Ganz, P.A. (1991). Psychosocial issues in lung cancer patients (Part 1). Chest, 99, 216–223.CrossRefGoogle Scholar
Cella, D.F., Orofiamma, B., Holland, J.C., Silberfarb, P.M., Tross, S., Feldstein, M., Perry, M., Maurer, L.H., Comis, R., & Orav, E.J. (1987). The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer. Cancer, 60, 1661–1667.3.0.CO;2-4>CrossRefGoogle Scholar
Cotton, S.P., Levine, E.G., Fitzpatrick, C.M., Dold, K.H., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8, 429–438.3.0.CO;2-P>CrossRefGoogle Scholar
Dales, R.E., Belanger, R., Shamji, F.M., Leech, J., Crepeau, A., & Sachs, H.J. (1994). Quality-of-life following thoracotomy for lung cancer. Journal of Clinical Epidemiology, 47, 1443–1449.CrossRefGoogle Scholar
Edmonds, C.V., Lockwood, G.A., & Cunningham, A.J. (1999). Psychological response to long-term group therapy: A randomized trial with metastatic breast cancer patients. Psycho-Oncology, 8, 74–91.3.0.CO;2-K>CrossRefGoogle Scholar
Eysenck, S.B.G., Eysenck, H.J., & Barret, P. (1985). A revised version of the psychoticism scale. Personality and Individual Differences, 6, 21–29.CrossRefGoogle Scholar
Faller, H., Bulzebruck, H., Drings, P., & Lung, H. (1999). Coping, distress, and survival among patients with lung cancer. Archives of General Psychiatry, 56, 756–762.CrossRefGoogle Scholar
Fukui, S., Kugaya, A., Okamura, H., Kamiya, M., Koike, M., Nakanishi, T., Imoto, S., Kanagawa, K., & Uchitomi, Y. (2000). A psychosocial group intervention for Japanese women with primary breast carcinoma. Cancer, 89, 1026–1036.3.0.CO;2-5>CrossRefGoogle Scholar
Grassi, L. & Rosti, G. (1996). Psychosocial morbidity and adjustment to illness among long-term cancer survivors. A six-year follow-up study. Psychosomatics, 37, 523–532.Google Scholar
Grassi, L., Rosti, G., Lasalvia, A., & Marangolo, M. (1993). Psychosocial variables associated with mental adjustment to cancer. Psycho-Oncology, 2, 11–20.CrossRefGoogle Scholar
Greer, S., Moorey, S., Baruch, J.D., Watson, M., Robertson, B.M., Mason, A., Rowden, L., Law, M.G., & Bliss, J.M. (1992). Adjuvant psychological therapy for patients with cancer: A prospective randomised trial. British Medical Journal, 304, 675–680.CrossRefGoogle Scholar
Hamelmann, H., Thermann, M., Muller-Schwefe, T., Schnurer, C., & Troidl, H. (1983). Surgically treated bronchial carcinoma patients—results of systematic follow-up. Thoracic and Cardiovascular Surgery, 31, 41–44.CrossRefGoogle Scholar
Hosokawa, T. & Ohyama, M. (1993). Reliability and validity of a Japanese version of the short-form Eysenck personality questionnaire-revised. Psychological Report, 72, 823–832.CrossRefGoogle Scholar
Maguire, P. (1982). Psychiatric morbidity associated with mastectomy. Experientia, 41(Suppl. 1), 373–380.Google Scholar
Maunsell, E., Brisson, J., & Deschenes, L. (1995). Social support and survival among women with breast cancer. Cancer, 76, 631–637.3.0.CO;2-9>CrossRefGoogle Scholar
Montazeri, A., Gillis, C.R., & McEwen, J. (1998). Quality of life in patients with lung cancer: A review of literature from 1970 to 1995. Chest, 113, 467–481.CrossRefGoogle Scholar
Mountain, C.F. (1986). A new international staging system for lung cancer. Chest, 89(Suppl. 1), 225–233.CrossRefGoogle Scholar
Naruke, T., Goya, T., Tsuchiya, R., & Suemasu, K. (1988). Prognosis and survival in resected lung carcinoma based on the new international staging system. Journal of Thoracic and Cardiovascular Surgery, 96, 440–447.Google Scholar
Nordin, K. & Glimelius, B. (1998). Reactions to gastrointestinal cancer variation in mental adjustment and emotional well-being over time in patients with different prognoses. Psycho-Oncology, 7, 413–423.3.0.CO;2-Q>CrossRefGoogle Scholar
Nou, E. & Aberg, T. (1980). Quality of survival in patients with surgically treated bronchial carcinoma. Thorax, 35, 255–263.CrossRefGoogle Scholar
Okano, Y., Okamura, H., Watanabe, T., Narabayashi, M., Katsumata, N., Ando, M., Adachi, I., Kazuma, K., Akechi, T., & Uchitomi, Y. (2001). Mental adjustment to first recurrence and correlated factors in patients with breast cancer. Breast Cancer Research and Treatment, 67, 255–262.CrossRefGoogle Scholar
Parkin, D.M., Pisani, P., & Ferlay, J. (1999). Estimates of the worldwide incidence of 25 major cancers in 1990. International Journal of Cancer, 80, 827–841.3.0.CO;2-P>CrossRefGoogle Scholar
Pisani, P., Parkin, D.M., Bray, F., & Ferlay, J. (1999). Estimates of the worldwide mortality from 25 cancers in 1990. International Journal of Cancer, 83, 18–29.3.0.CO;2-M>CrossRefGoogle Scholar
Spitzer, R.L., Williams, J.B.W., Gibbon, M., & First, M.B. (1990). Structured Clinical Interview for DSM III-R. Washington, DC: American Psychiatric Press.
Uchitomi, Y., Mikami, I., Kugaya, A., Akizuki, N., Nagai, K., Nishiwaki, Y., Akechi, T., & Okamura, H. (2000). Depression after successful treatment for nonsmall cell lung carcinoma. Cancer, 89, 1172–1179.3.0.CO;2-U>CrossRefGoogle Scholar
Watson, M., Greer, S., Rowden, L., Gorman, C., Robertson, B., Bliss, J.M., & Tunmore, R. (1991). Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychological Medicine, 21, 51–57.CrossRefGoogle Scholar
Watson, M., Greer, S., Young, J., Inayat, Q., Burgess, C., & Robertson, B. (1988). Development of a questionnaire measure of adjustment to cancer: The MAC scale. Psychological Medicine, 18, 203–209.CrossRefGoogle Scholar
Watson, M., Haviland, J.S., Greer, S., Davidson, J., & Bliss, J.M. (1999). Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet, 354, 1331–1336.CrossRefGoogle Scholar