title: Family physician involvement in cancer care and lung cancer patient emotional distress and quality of life.
abstract: OBJECTIVE
  This study aims to describe emotional distress and quality of life (QoL) of patients at different phases of their lung cancer and the association with their family physician (FP) involvement.
  
  
  METHODS
  A prospective study on patients with lung cancer was conducted in three regions of Quebec, Canada. Patients completed, at baseline, several validated questionnaires regarding their psychosocial characteristics and their perceived level of FP involvement. Emotional distress [profile of mood states (POMS)] and QoL [European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30)] were reassessed every 3-6 months, whether patients had metastasis or not, up to 18 months. Results were regrouped according to cancer phase. Mixed models with repeated measurements were performed to identify variation in distress and QoL.
  
  
  RESULTS
  In this cohort of 395 patients, distress was low at diagnosis (0.79 ± 0.7 on a 0-4 scale), raising to 1.36 ± 0.8 at the advance phase (p < 0.0001). Patient's global QoL scores significantly decreased from the diagnosis to the advance phase (from 66 to 45 on a 0-100 scale; p < 0.0001). At all phases of cancer, FP involvement was significantly associated with patients' distress (p = 0.0004) and their global perception of QoL (p = 0.0080). These associations remained statistically significant even after controlling for age, gender, and presence of metastases.
  
  
  CONCLUSIONS
  This study provides new knowledge on patients' emotional distress and QoL with cancer evolution and, particularly, their association with FP involvement. Other studies should be conducted to further explore FP role in cancer supportive care.
authors.affiliation: Quebec Center of Excellence on Aging, Quebec, QC, Canada. michele.aubin@mfa.ulaval.ca
authors.forename: Michèle
authors.initials: M
authors.lastname: Aubin
authors.forename: Lucie
authors.initials: L
authors.lastname: Vézina
authors.forename: René
authors.initials: R
authors.lastname: Verreault
authors.forename: Lise
authors.initials: L
authors.lastname: Fillion
authors.forename: Eveline
authors.initials: E
authors.lastname: Hudon
authors.forename: François
authors.initials: F
authors.lastname: Lehmann
authors.forename: Yvan
authors.initials: Y
authors.lastname: Leduc
authors.forename: Rénald
authors.initials: R
authors.lastname: Bergeron
authors.forename: Daniel
authors.initials: D
authors.lastname: Reinharz
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010821:Physicians, Family / Q000458:organization & administration*; D024382:Professional Role; D011446:Prospective Studies; D011788:Quality of Life; D011792:Quebec; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires