title: A longitudinal qualitative analysis of the factors that influence patient distress within the lung cancer population.
abstract: BACKGROUND
  The literature consistently shows that lung cancer patients experience both greater number of symptoms and concerns about health and existential issues compared with patients from other cancer populations and that patient distress near diagnosis predicts survival in lung cancer patients. Also evidence suggests that symptom characteristics (e.g. symptom intensity and frequency) influence distress. The relationship between aspects of patients' symptom experiences can be complex and the mechanisms underpinning this association are not fully understood at present.
  
  
  METHODS
  Semi-structured interviews were conducted with 17 lung cancer patients and 15 primary caregivers at four time points: at the beginning of treatment and then subsequently at three, six, and twelve months, providing a total of 44 patient and 32 caregiver interviews. Interpretative Phenomenological Analysis was employed in the data analysis.
  
  
  RESULTS
  The analysis presented here concentrates on two areas which was reported to influence distress in this population: (1) patients' perception of symptoms and symptom characteristics and their associated distress; and (2) the relationship between patients' causal reasoning and their distress.
  
  
  CONCLUSIONS
  The complexity of the issues involved in the development of symptom distress needs to be recognised by health care professionals in this poor prognosis group of patients. Better patient preparation about symptoms may alleviate some of the symptom distress in lung cancer patients.
authors.affiliation: School of Nursing, Midwifery & Social Work, University of Manchester, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lowe
authors.forename: A
authors.initials: A
authors.lastname: Molassiotis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059031:Anticipation, Psychological; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology; D059248:Chemoradiotherapy; D032882:Comprehension; D018450:Disease Progression; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011573:Psychoanalytic Interpretation; D012307:Risk Factors; D013315:Stress, Psychological; D016019:Survival Analysis