Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK.
Psychooncology. 2019 Apr;28(4):718-725. doi: 10.1002/pon.5005. Epub 2019 Feb 12.
The incidence of lung cancer is four times higher in people with chronic obstructive pulmonary disease (COPD) compared with the general population. Promotion of a shorter time from symptom onset to presentation is one potential strategy for earlier lung cancer diagnosis, but distinguishing respiratory symptoms can be difficult. We investigated how the experience of COPD influences symptom appraisal and help seeking for potential lung cancer symptoms.
We conducted qualitative interviews with men (n = 17) and women (n = 23) aged 40 to 83 years with COPD. Topic guides drew on the integrated symptom-response framework and covered symptom experience, interpretation, action, recognition, help seeking, evaluation, and reevaluation. We used the framework method to analyse the data.
Participants said that they attributed chest symptoms to their COPD; no other cause was considered. Participants said that family/friends noticed changes in their symptoms and encouraged help seeking. Others felt isolated by their COPD because they could not get out, were fatigued, or were embarrassed. Participants visited health professionals frequently, but increased risk of lung cancer was not discussed.
Our study provides insight into different levels of influence on symptom appraisal and targets for intervention. Greater awareness of increased lung cancer risk and support to act on symptom changes is essential and could be achieved through a concerted information campaign. Health professionals working with people with COPD could also optimise appointments to support symptom appraisal of potential lung cancer symptoms.
与普通人群相比，慢性阻塞性肺疾病（COPD）患者的肺癌发病率高出四倍。促进从症状出现到就诊的时间更短是早期肺癌诊断的潜在策略之一，但区分呼吸系统症状可能具有挑战性。我们研究了 COPD 的发病经历如何影响对潜在肺癌症状的症状评估和寻求帮助。
我们对年龄在 40 至 83 岁之间的 COPD 男性（n=17）和女性（n=23）进行了定性访谈。主题指南借鉴了综合症状反应框架，涵盖了症状体验、解释、行动、识别、寻求帮助、评估和重新评估。我们使用框架方法对数据进行分析。
参与者表示，他们将胸部症状归因于 COPD；没有考虑其他原因。参与者表示，家人/朋友注意到他们的症状发生了变化，并鼓励他们寻求帮助。其他人则因为无法外出、疲劳或尴尬而感到孤立。参与者经常去看卫生专业人员，但未讨论肺癌风险增加的问题。
我们的研究深入了解了对症状评估的不同程度的影响和干预目标。提高对增加的肺癌风险的认识并支持对症状变化采取行动至关重要，这可以通过协调一致的信息宣传活动来实现。与 COPD 患者合作的卫生专业人员也可以优化预约，以支持对潜在肺癌症状的症状评估。
