Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
J Cancer Surviv. 2024 Dec;18(6):1754-1770. doi: 10.1007/s11764-023-01417-x. Epub 2023 Jul 27.
Lung cancer remains underrepresented in cancer survivorship research. This study aimed to understand survivors' physical/psychological challenges, experiences of immunotherapy (IO) and targeted therapy (TT), and psychological adjustment through application of the Roberts et al. (2017) advanced cancer adaptation of Folkman and Greer's appraisal and coping model.
Adults 6-24 months post-initial treatment completion were recruited via an Australian cohort study. Participant demographic, clinical, quality of life, and distress data were obtained through the cohort database. Qualitative interviews were conducted and analyzed using Framework methods. Roberts et al. (2017)'s model informed data interpretation and presentation.
Twenty interviews were conducted (10 females; average age 69 years). Participants' diagnostic stages varied (stage I = 2, stage II = 4, stage III = 8, stage IV = 6); most had received IO/TT (n = 14) and were on average 17 months (range 10-24) post-diagnosis. Three themes were identified and mapped to the Roberts' framework: (1) Ongoing illness events: most participants reported functioning well despite ongoing physical effects. Those on IO/TT reported side effects; some were unexpected/serious. (2) Adjusting to life with lung cancer: most expressed hope for the future while simultaneously preparing for disease progression. Those receiving IO/TT experienced uncertainty given limited survival information. (3) Learning to live with lung cancer: participants described emotion, problem, and meaning based on coping strategies.
Findings may guide development of supportive care resources/interventions focused on uncertainty, IO/TT communication and decision-making, and coping.
Many people with lung cancer are living well with their ongoing illness. Despite challenges, many survivors are adapting to issues as they arise and are maintaining a sense of hope and optimism.
肺癌在癌症生存研究中代表性不足。本研究旨在通过应用 Roberts 等人（2017 年）对 Folkman 和 Greer 的评估和应对模型的晚期癌症适应性，了解幸存者的身体/心理挑战、免疫疗法（IO）和靶向治疗（TT）的体验，以及心理调整。
通过澳大利亚队列研究招募初始治疗完成后 6-24 个月的成年人。通过队列数据库获得参与者的人口统计学、临床、生活质量和困扰数据。进行定性访谈，并使用框架方法进行分析。Roberts 等人（2017 年）的模型为数据解释和呈现提供了信息。
进行了 20 次访谈（10 名女性；平均年龄 69 岁）。参与者的诊断阶段各不相同（I 期=2，II 期=4，III 期=8，IV 期=6）；大多数接受过 IO/TT（n=14），平均诊断后 17 个月（10-24 个月）。确定了三个主题，并映射到 Roberts 框架：（1）持续的疾病事件：大多数参与者报告尽管存在身体影响，但功能良好。接受 IO/TT 的人报告了副作用；有些是意外的/严重的。（2）适应肺癌的生活：大多数人对未来充满希望，同时为疾病进展做准备。接受 IO/TT 的人由于生存信息有限而感到不确定。（3）学会与肺癌共存：参与者根据应对策略描述了情绪、问题和意义。
研究结果可能指导开发侧重于不确定性、IO/TT 沟通和决策以及应对的支持性护理资源/干预措施。
许多肺癌患者的病情仍在持续，但生活得很好。尽管存在挑战，但许多幸存者正在适应出现的问题，并保持希望和乐观的态度。
