Psychological Distress in Surgical Lung Cancer Patients: Trajectories, Influencing Factors and Impacts on Quality of Life.

Aims: To investigate psychological distress trajectories in surgical lung cancer patients and their influencing factors, and explore the impact of trajectories on quality of life (QoL).

Design: Prospective longitudinal study.

Methods: Data from 324 patients at a Chinese tertiary hospital were collected within 48 h of admission (T0), 3 days after surgery (T1), 2 weeks (T2), 3 months (T3), 6 months (T4) and 1 year after discharge (T5). Latent class growth models identified psychological distress trajectories, logistic regression analysed their influencing factors, and linear regression analysed the effects of psychological distress trajectories on QoL.

Results: Psychological distress peaked at T1, then decreased steadily. Three trajectories emerged: low-level stable group (Class 1, 45.06%), intermediate-level decreased group (Class 2, 39.51%) and high-level stable group (Class 3, 15.43%). Compared with Class 1, Class 3 was predicted by surgical modality, lymph node metastasis, postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy, while Class 2 was predicted by surgical modality, postoperative adjuvant therapy and self-efficacy. Furthermore, psychological distress trajectories negatively predicted QoL.

Conclusions: Surgical lung cancer patients experience an initial increase in psychological distress, followed by a gradual decline, with three distinct trajectories. Surgical modality, lymph node metastasis, and postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy were the major influencing factors of psychological distress trajectories. Persistent distress adversely impacts QoL, underscoring the need for early, personalised psychological interventions to improve long-term outcomes.