Identifying primary concerns in patients newly diagnosed with lung cancer

Oncol Nurs Forum. 2011 Jul;38(4):440-7. doi: 10.1188/11.ONF.440-447.


Purpose/objectives: 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.

Design: 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.

Setting: A comprehensive cancer center and a Veterans Affairs medical center in the midwestern United States.

Sample: 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.

Main research variables: Illness perceptions, worry, and health environment experience.

Findings: 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.

Implications for nursing: 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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology*
  • Attitude to Health*
  • Female
  • Health Facility Environment*
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / psychology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Period
  • Preoperative Period
  • Qualitative Research