Thomas R Valentine, Kylie R Park, Carolyn J Presley, Peter G Shields, Barbara L Andersen
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Abstract
Objective: Advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden of mental and physical symptoms. Across illnesses, patients' subjective illness beliefs (i.e., illness perceptions [IPs]) correlate with psychological and physical health status. Despite this, IPs in NSCLC patients are understudied. To address this gap, previous research identified three profiles characterizing IPs of newly diagnosed NSCLC patients: "coping" (those more positive perceptions of NSCLC); "coping but concerned" (similar positive perceptions but high concern); and "struggling" (uniformly negative perceptions; Valentine et al., 2022). This extension seeks to determine if IPs are predictive. Would patients' psychological and physical health trajectories differ by IP profile?
Method: Patients with Stage IV NSCLC (N = 186) from a prospective cohort (2017-2019; NCT03199651) enrolled at diagnosis participated and completed an IP measure and anxiety, depression, physical symptom, and health status outcome measures monthly for 8 months. Linear mixed models tested profile membership (see above) as predictive of outcome trajectories, with those "struggling" having the poorest outcomes.
Results: Eight-month trajectories for anxiety and some physical symptoms showed significant improvement, whereas depression, dyspnea, pain, and self-rated health did not. As anticipated, profile membership was predictive: "struggling" profile patients reported significantly worse anxiety and depression symptoms, physical symptoms, and health compared to "coping" patients. There were no interactions between profile and time. Generalization to samples from U.S. states with greater racial/ethnic diversity is unknown.
Conclusion: Novel data show "struggling" profile patients to have uniformly negative outcomes and specify IP content relevant for inclusion in cognitive behavioral therapies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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