Optimal communication associated with lower risk of acute traumatic stress after lung cancer diagnosis

• Published in: Supportive care in cancer Vol. 30; no. 1; pp. 259 - 269
• Main Authors: Hardardottir, Hronn, Aspelund, Thor, Zhu, Jianwei, Fall, Katja, Hauksdottir, Arna, Fang, Fang, Lu, Donghao, Janson, Christer, Jonsson, Steinn, Valdimarsdottir, Heiddis, Valdimarsdottir, Unnur A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2022; Springer; Springer Nature B.V
• Subjects: Cancer; Clinical significance; Cohort analysis; Communication; Diagnosis; Doctor-patient communication; Health aspects; Health psychology; Humans; Lung cancer; Lung cancer diagnosis; Lung Neoplasms - diagnosis; Medical colleges; Medical diagnosis; Medical personnel; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Patients; Post traumatic stress disorder; Post-diagnostic acute stress; Posttraumatic stress disorder (PTSD); Prospective cohort study; Rehabilitation Medicine; Risk Factors; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; Lung cancer diagnosis; Post-diagnostic acute stress; Doctor-patient communication; Posttraumatic stress disorder (PTSD); Prospective cohort study
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-021-06138-4

Purpose The aim of this study was to assess the role of the patient’s background and perceived healthcare-related factors in symptoms of acute stress after lung cancer diagnosis. Methods The study population consisted of 89 individuals referred for diagnostic work-up at Landspitali National University Hospital in Iceland and subsequently diagnosed with lung cancer. Before diagnosis, the patients completed questionnaires on sociodemographic characteristics, pre-diagnostic distress (Hospital Anxiety and Depression Scale), social support, and resilience. At a median of 16 days after diagnosis, the patients reported symptoms of acute stress on the Impact of Event Scale-Revised (IES-R) and experience of communication and support from healthcare professionals and family during the diagnostic period. Results Patients were on average 68 years and 52% reported high levels of post-diagnostic acute stress (IES-R > 23) while 24% reported symptoms suggestive of clinical significance (IES-R > 32). Prior history of cancer ( β = 6.7, 95% CI: 0.1 to 13.3) and pre-diagnostic distress were associated with higher levels of post-diagnostic acute stress ( β = 8.8, 95% CI: 2.7 to 14.9), while high educational level ( β = − 7.9, 95% CI: − 14.8 to − 1.1) was associated with lower levels. Controlling for the abovementioned factors, the patients’ perception of optimal doctor-patient ( β = − 9.1, 95% CI: − 14.9 to − 3.3) and family communication ( β = − 8.6, 95% CI: − 14.3 to − 2.9) was inversely associated with levels of post-diagnostic acute stress after lung cancer diagnosis. Conclusions A high proportion of patients with newly diagnosed lung cancer experience high levels of acute traumatic stress of potential clinical significance. Efforts to improve doctor-patient and family communication may mitigate the risk of these adverse symptoms.