Psychosocial Challenges for Patients With Advanced Lung Cancer: Interventions to Improve Well-being

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the ONA take:

Patients with lung malignancies are faced with high symptom burden, poorer prognosis, and stigmatization. Therefore, they experience greater psychological distress and lower quality of life. In addition, the negative impact of the association with smoking behaviors can further limit social support for patients with lung cancer.

Improving psychosocial well-being is essential to enhance quality of life for these patients. Research on psychosocial interventions demonstrate their efficacy in patients with cancer; however, their impact on patients with lung cancer is understudied compared with other cancers.

In this article, a review of the growing body of literature on evidence-based psychosocial-oriented interventions to support wellness for patients with lung cancer at all stages of survivorship is presented. Also discussed are methodological issues and other potential bias of the studies, and the barriers associated with including patients with lung cancer in these studies.

Lung Cancer: Targets and Therapy
Lung Cancer: Targets and Therapy

Abstract: As compared to other cancers, lung malignancies are associated with high symptom burden, poorer prognosis, and stigmatization. Such factors increase psychological distress and negatively impact quality of life. Research has documented the efficacy of psychosocial interventions to alleviate psychological distress and promote well-being among patients with cancer. This article summarizes the current literature on psychosocial interventions in lung cancer. Major types of psychosocial interventions in lung cancer include cognitive-behavioral therapies, psycho-education, mind–body, exercise, and supportive or palliative care strategies. Discussion relative to the purpose, sample, research design, outcomes, and quality of the studies is presented. Findings may be useful in clinical environments as a resource to help health providers better understand mental health treatment options and care for patients facing lung cancer. The need to direct future research toward the advancement of science and improve well-being and quality of life outcomes for patients with advanced lung cancer and their family members is discussed.


Keywords: lung cancer, psychosocial interventions, psychological distress, quality of life, advanced lung cancer 

INTRODUCTION

A diagnosis of lung cancer, the second leading cancer in incidence among men and women and leading cause of cancer death,1 is associated with high symptom burden, poorer prognosis, and stigma associated with links to smoking behaviors.2–5 Such factors increase psychological distress and negative social impacts of the disease on patients and their families.2 Thus, improving psychosocial well-being to enhance the quality of life (QOL) is a primary goal at all stages of lung cancer during treatment and survivorship.5 Research has shown that psychological distress, such as that occurs during depressive episodes, can be a prognostic indicator of poorer clinical outcomes and survival for patients with cancer.2, 6 Despite this observation, lung cancer remains understudied in the area of psychosocial care as compared to other cancers,2 even with the recognition of unmet supportive needs.7 Therefore, the purpose of this article is to provide a current overview about research-based psychosocial interventions to support wellness for patients with advanced lung cancer across the survivorship spectrum with a discussion of findings in the context of trends in the field and updated evidence.

A growing literature documents psychosocial-oriented interventions to support mental health for patients with cancer.6,8,9 Such interventions include a wide-ranging host of options such as cognitive-behavioral therapies (CBTs), problem-solving approaches, mind–body and alternative therapies, supportive group-based treatments, and education focused modalities.9–11 While research demonstrates that many of the approaches are efficacious in managing psychological symptoms and in promoting facets of well-being, studies persist with methodological problems such as samples that did not have distress prior to intervention induction, lack of randomization and blinding, variability in identified interventions and outcomes, and other potential bias.8,10,12 In general, barriers associated with the inclusion of patients with lung cancer in the intervention studies include the presence of high symptom burden and the challenges associated with access to study sites that require physical presence at the designated times. Patients with lung cancer are recognized to have higher needs for comprehensive supportive care, and given both poor physical function and psychological distress, may need interventions that are multimodal in nature.7,13,14  

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