Quality of life among newly diagnosed lung cancer patients in Iceland: The role of resilience and social support

Abstract

Lung cancer is one of the most commonly diagnosed cancer world-wide and leading causes of cancer deaths in the developed world. A diagnosis of lung cancer is a severely stressful event illustrated by the dramatic increase in psychiatric disorders in newly diagnosed population. Nevertheless, there is a great variability in how patients respond to the diagnosis of cancer. This may be partly explained by the nature and quality of support that patients have, individuals coping skills and resilience. The purpose of this study was to assess the quality of life of patients with newly diagnosed lung cancer and the potential role of social support and resilience on their quality of life. The study was a prospective cohort study at the pulmonary department at Landspitali, University Hospital in Iceland. The study cohort consisted of 35 patients referred for a diagnostic work up due to suspected lung cancer and followed until the lung cancer diagnosis was established. Social support was assessed with Berkman-Syme Social Network Index (SNI) and resilience was measured using Connor Davidson resilience scale (CD-RISC-10) at the diagnostic work up. Items from the Functional Assessment for Cancer Therapy-Lung Cancer (FACT-L) were used to measure quality of life after lung cancer diagnosis. The mean age of participants was 71 years; women representing half of the population. Younger patients (60-69 years) reported higher social support (p=0.02) compare to older patients (70 years or older), but no other statistically significant association was found between background/clinical characteristic and social support and resilience. Women reported better functional wellbeing (FWB) compared to men (p=0.05). Higher levels of social support prior to cancer diagnosis was associated with better social/family wellbeing (SWB) following cancer diagnosis (p=0.02). No statistically significant association was found between resilience and quality of life. Yet, both emotional well-being (EWB) and general well-being (FACT-G) were marginally associated with resilience (p=0.09) when adjusted for gender and age. This is the first study in Iceland on the quality of life of newly diagnosed patients with lung cancer. Although limited by small numbers the findings suggest that social support and resilience may be associated with better quality of life shortly after lung cancer diagnosis.

Nýgreiningar og dánartíðni vegna lungnakrabbameins er enn hæst allra krabbameina í hinum vestræna heimi ef undanskilin eru nýgreiningar brjóstakrabbameina og blöðruhálskirtilskrabbameina. Að greinast með krabbamein hefur mikil áhrif á líðan sjúklinga en rannsóknir benda til verulegrar aukningar í tíðni ýmissa geðraskana á borð við kvíða og þunglyndis meðal nýgreindra krabbameinssjúklinga. Viðbrögð einstaklinga við greiningu krabbameins eru hins vegar mjög ólík, hugsanlega vegna mismunandi bjargráða og/eða seiglu einstaklinga sem og aðgengi að félagslegum stuðningi. Markmið þessara rannsóknar var að kortleggja lífsgæði nýgreindra einstaklinga með lungnakrabbamein og meta áhrif félagslegs stuðnings og seiglu á alla meinþætti lífsgæða þeirra. Rannsóknarsniðið er framsýn ferilrannsókn. Þátttakendur voru 35 einstaklingar sem gengust undir greiningarrannsóknir vegna gruns um lungnakrabbamein. Þeir svöruðu spurningalistum um félagslegan stuðning og seiglu fyrir staðfesta greiningu og einnig spurningum um lífsgæði eftir að greining lungnakrabbameins var staðfest en áður en meðferð var hafin. Félagslegur stuðningur var metin með Berkman Syme Social Network Index (SNI) spurningalistanum og seigla var mæld með Connor Davidson seiglu skemanu (CD-RISC-10) fyrir greiningu lungnakrabbameins. Lífsgæði voru metin með spurningum úr Functional Assessment of Cancer Therapy-Lung (FACT-L). Meðalaldur þátttakenda var 71 ár og kynjahlutfallið var jafnt. Almennt tjáðu einstaklingar yngri en 70ára meiri félagslegan stuðning miðað við þá sem voru eldri en 70 ára (p=0,02) en engin önnur tölfræðilega marktæk tengsl sáust á milli bakgrunnsþátta og félagslegs stuðnings og seiglu. Konur tjáðu meiri virkni (FWB) samkvæmt FACT-L lífsgæðakvarðanum samanborið við karla (p=0,05). Jákvæð tengsl voru á milli hærri félagslegs stuðnings fyrir greiningu og tengsla við vini og fjölskyldu (SWB) eftir greiningu (p=0,02). Engin tölfræðilegur munur sást á milli seiglu og lífsgæðaþátta. Aftur á móti voru vísbendingar um að einstaklingar með meiri seiglu fyrir hefðu betri andlega (EWB) og almenna líðan (FACT-G) eftir greiningu, þegar leiðrétt hafði verið fyrir aldri og kyni (p=0,09). Þetta er fyrsta rannsóknin á Íslandi á lífsgæðum einstaklinga með nýgreint lungnakrabbamein. Þrátt fyrir fáa þátttakendur og takmarkað tölfræðilegt afl gefa niðurstöðurnar vísbendingar um að seigla og félagslegur stuðningur geti haft jákvæð áhrif á lífsgæði einstaklinga skömmu eftir greiningu lungnakrabbameins.