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Women With Lung Cancer: Quality of Life After Thoracotomy: A 6-Month Prospective Study

Sarna, Linda DNSc, RN, FAAN; Cooley, Mary E. PhD, RN, CS; Brown, Jean K. PhD, RN, FAAN; Chernecky, Cynthia PhD, RN, FAAN; Padilla, Geraldine PhD; Danao, Leda PhD, RN; Chakravarty, Deepalika MS; Elashoff, David PhD

doi: 10.1097/NCC.0b013e3181be5e51

Background: Data about health-related quality of life (QOL) after surgical treatment for lung cancer are limited. Such information can be valuable in developing appropriate nursing interventions for follow-up care for survivors.

Objectives: The purposes of this study were to describe physical and emotional QOL of disease-free female non-small cell lung cancer (NSCLC) survivors and to determine characteristics associated with greater risk for disruptions.

Methods: One-hundred-nineteen women surgically treated for NSCLC completed the Short-Form 36 (as a measure of physical and mental QOL) along with health status assessments (including comorbidity, depression, Center for Epidemiologic Studies-Depression Scale, smoking status, and body mass index), dyspnea (Dyspnea Index), meaning of illness, and demographic and clinical information at baseline and 3 and 6 months.

Results: On average, the women were 68 years of age, diagnosed 2 years previously, had adenocarcinoma, and were treated surgically with lobectomy. The majority (66%) had comorbid disease, 29% had depressed mood (Center for Epidemiologic Studies-Depression Scale score ≥16), 8% were current smokers, 62% were overweight, 22% had dyspnea (scores ≥2), and 24% had a negative meaning of illness. Physical and emotional QOL scores were comparable to Short-Form 36 norms for older adults and exhibited little change over time. Controlling for time since diagnosis, dyspnea, and depressed mood were strongly related to disruptions in physical and emotional QOL, respectively, across the 6-month study period, with comorbid disease contributing to both models.

Conclusion: Depressed mood, comorbidities, and dyspnea were factors related to poorer physical and emotional QOL. Survivors with these characteristics might benefit from greater supportive care.

Implications for Practice: Screening for dyspnea, depressed mood, and comorbid illness can identify female survivors at-risk for poorer QOL after surgery.

Authors' Affiliations: School of Nursing, University of California, Los Angeles (Drs Sarna and Padilla); Dana-Farber Cancer Institute, Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Boston, Massachusetts (Dr Cooley); School of Nursing, University at Buffalo, State University of New York (Dr Brown); School of Nursing, Medical College of Georgia (Dr Chernecky); Jonsson Comprehensive Cancer Center, University of California, Los Angeles (Dr Danao); Center for AIDS Prevention Studies, University of California, San Francisco (Ms Chakravarty); and David Geffen School of Medicine, University of California, Los Angeles (Dr Elashoff).

This study was funded by the Oncology Nursing Foundation Center for Leadership, Information, and Research (no. 018652).

Corresponding author: Linda Sarna, DNSc, RN, FAAN, School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, Box 956918, Los Angeles, CA 90095-6916 (

Accepted for publication August 27, 2009.

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