Section of General Thoracic Surgery, University of California, Davis Health, Sacramento, California; Center for Healthcare Policy and Research, University of California, Davis Health, Sacramento, California.
Center for Healthcare Policy and Research, University of California, Davis Health, Sacramento, California.
Ann Thorac Surg. 2020 Dec;110(6):1840-1846. doi: 10.1016/j.athoracsur.2020.05.080. Epub 2020 Jul 21.
Lung cancer surgery has a significant impact on health-related quality of life (HRQOL). In prior studies of HRQOL after lung cancer surgery, researchers selected the HRQOL domains of interest. To increase the patient-centeredness of these studies, we conducted a qualitative study to ascertain which aspects of HRQOL are most relevant to them postoperatively and to identify Patient-Reported Outcome Measurement Information System measures most germane to patients undergoing lobectomy for lung cancer.
We conducted in-depth semistructured interviews with 25 patients after lobectomy for lung cancer to solicit input regarding the physical, social, and emotional HRQOL domains relevant after surgery. Interviews were transcribed verbatim, and a thematic content analysis to identify HRQOL themes was performed. Themes were integrated to create a conceptual framework to guide outcome measurement selection.
Qualitative analysis indicated that within the physical health domain, patients were most concerned about general physical function (100% of participants), pain (96%), fatigue (96%), and dyspnea (76%). Neuropathic pain was reported by 28% of participants. Instrumental (100%) and emotional social support (88%) and positive emotions/relief/hope (96%) were also important. Two cross-cutting themes were the desire to maintain independence (32%) and preparing for surgery/expectations (92%).
Our results indicate that a number of physical, social, and emotional HRQOL domains are relevant after lobectomy for lung cancer. These domains are currently represented by Patient-Reported Outcome Measurement Information System measures and can be readily assessed for clinical or research purposes.
肺癌手术对健康相关生活质量（HRQOL）有显著影响。在既往肺癌手术后 HRQOL 的研究中，研究人员选择了感兴趣的 HRQOL 领域。为了增加这些研究的以患者为中心性，我们进行了一项定性研究，以确定手术后与患者最相关的 HRQOL 方面，并确定与肺癌肺叶切除术患者最相关的患者报告结局测量信息系统（PROMIS）测量指标。
我们对 25 例肺癌肺叶切除术后患者进行了深入的半结构式访谈，以征求他们对手术后相关的身体、社会和情感 HRQOL 领域的意见。访谈记录逐字转录，并进行主题内容分析以确定 HRQOL 主题。主题被整合以创建一个概念框架，以指导结果测量的选择。
定性分析表明，在身体健康领域，患者最关注一般身体功能（100%的参与者）、疼痛（96%）、疲劳（96%）和呼吸困难（76%）。28%的参与者报告有神经性疼痛。工具性（100%）和情感社会支持（88%）以及积极的情绪/缓解/希望（96%）也很重要。两个交叉主题是保持独立性的愿望（32%）和为手术做准备/期望（92%）。
我们的结果表明，肺癌肺叶切除术后有许多身体、社会和情感 HRQOL 领域是相关的。这些领域目前由 PROMIS 测量指标代表，可以方便地用于临床或研究目的进行评估。
