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Quality of Life in Patients With Non–Small Cell Lung Cancer

Structural Equation Modeling

Lee, Jung Lim PhD; Jeong, Younhee PhD

doi: 10.1097/NCC.0000000000000645
Article: PDF Only

Background Quality of life (QOL) is important for cancer patients, even for survival. However, factors affecting QOL of non–small cell lung cancer (NSCLC) patients have not been studied sufficiently.

Objective The aims of this study were to understand the relationships among social support, resilience, distress, and symptom and to identify predictors of QOL for NSCLC patients.

Methods Participants were 212 adult patients who visited an outpatient department at a tertiary hospital located in Seoul, Korea. Data were collected using self-reported questionnaires and clinical records.

Results Social support, resilience, distress, symptom burden, and QOL explained 99.9% of the variance in QOL. Social support was not a significant predictor of distress and QOL, but a significant predictor of resilience. Resilience was a significant predictor of both distress and QOL. Distress was not a significant predictor of QOL, but a significant predictor of symptom burden. Symptom burden was a significant predictor of QOL and had the largest direct effect on QOL. Resilience also had an important impact on QOL because resilience influenced QOL in various paths.

Conclusion This study suggests that social support, resilience, distress, and symptom burden are predictors of QOL in an NSCLC population. These predictors had direct and indirect effects on each other and on QOL.

Implications for Practice Developing an interventional program to increase resilience and social support as well as to decrease symptom burden and distress may be necessary to improve QOL of NSCLC patients.

Author Affiliations: Department of Nursing, Woosong University, Daejeon (Dr Lee); and College of Nursing Science and East-West Nursing Research Institute, Kyung Hee University, Seoul (Dr Jeong), Korea.

Correspondence: Younhee Jeong, PhD, College of Nursing Science, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Korea (

The authors have no funding or conflicts of interest to disclose.

Accepted for publication June 12, 2018.

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