title: Identifying primary concerns in patients newly diagnosed with lung cancer.
abstract: OBJECTIVE
  To compare illness concerns before and after surgery in patients newly diagnosed with early-stage lung cancer, and to determine whether perceived healthcare environment factors were associated with reduced concerns and cancer-related worry.
  
  
  METHODS
  Participants completed a semistructured interview using the conceptual content cognitive map (3CM) method. Important concepts were identified in a spatial array representative of a cognitive map of the illness.
  
  
  METHODS
  A comprehensive cancer center and a Veterans Affairs medical center in the midwestern United States.
  
  
  METHODS
  34 men (n=22) and women (n=12), aged 47-83 years (X=65, SD=10), with newly diagnosed lung cancer were interviewed at the time of diagnosis and again three to four weeks after surgery.
  
  
  METHODS
  Content and frequency analysis and descriptive statistics were used to characterize the data. Correlation studies and paired t tests were used to determine relationships among the main study variables.
  
  
  METHODS
  Illness perceptions, worry, and health environment experience.
  
  
  RESULTS
  Twelve primary content domains were identified pre- and postoperatively (seven negative and five positive). Cancer-related worry was related to negative content and to fears both before and after surgery. Positive health environment perceptions were related to positive content after surgery.
  
  
  CONCLUSIONS
  The findings demonstrate important areas of concern that can be targeted to reduce psychological distress and promote adaptation.
  
  
  CONCLUSIONS
  The willingness of nurses to identify concerns, assist patients to participate in care, and identify strategies to manage unresolved issues early in the treatment trajectory is integral to optimize long-term adjustment.
authors.affiliation: College of Nursing, Michigan State University, East Lansing, USA. rebecca.lehto@hc.msu.edu
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Lehto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D001294:Attitude to Health; D005260:Female; D006272:Health Facility Environment; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011184:Postoperative Period; D057234:Preoperative Period; D036301:Qualitative Research