Mental adjustment after surgery for non-small cell lung cancer.
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.


CONCLUSIONS
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.
Uchitomi
Yosuke
Y
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan. yuchitom@east.ncc.go.jp
Akechi
Tatsuo
T
Fujimori
Maiko
M
Okamura
Masako
M
Ooba
Akira
A
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008175:Lung Neoplasms / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D011446:Prospective Studies