Physician support and patient psychologic responses after surgery for nonsmall cell lung carcinoma: a prospective observational study.
BACKGROUND
In patients with cancer, depression and coping have been suggested to be important psychologic responses that may be associated with quality of life. Social support, especially from physicians, is considered important for cancer patients during their illness. The authors have investigated the impact of physician support on psychologic responses, including depression, psychologic distress and coping (such as fighting spirit and helplessness/hopelessness) in a cohort of patients with early-stage lung carcinoma.


METHODS
After curative resection for nonsmall cell lung carcinoma, 226 patients were enrolled in a longitudinal study. The extent of social support, including physician support, was measured in structured interviews conducted 1 and 3 months after surgery. During the interviews, psychologic responses were measured using the Structured Clinical Interview for DSM-III-R, the Profiles of Mood States, and the Mental Adjustment to Cancer scale. Univariate and multivariate analyses were used to examine the impact of physician support on psychologic responses.


RESULTS
Physician support had no effect on depression, but correlated negatively with psychologic distress (P < 0.05) and helplessness/hopelessness (P < 0.05), and positively with fighting spirit (P < 0.01). Multivariate analyses controlling for confounding biomedical and psychosocial variables revealed only physician support had a significant impact on fighting spirit, independently. However, this effect was limited to female patients or patients with no history of depression.


CONCLUSIONS
In postoperative patients with nonsmall cell lung carcinoma, physician support may have a significant impact on fighting spirit, but this effect appears to be limited to female patients or patients with no history of depression.
Uchitomi
Y
Y
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwanoha 6-5-1, Kashiwa, Chiba, 277-8577, Japan. yuchitom@east.ncc.go.jp
Mikami
I
I
Kugaya
A
A
Nakano
T
T
Okuyama
T
T
Akechi
T
T
Okamura
H
H
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology* / Q000601:surgery*; D003863:Depression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D011446:Prospective Studies; D012044:Regression Analysis; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control