Purpose Promoting health-related quality of life (HRQOL) is a primary goal of lung cancer treatment. Trauma history and distress can negatively impact HRQOL.Design A cross-sectional design examined the associations of trauma history, cancer-specific distress, and HRQOL.Sample/Method Sixty lung cancer patients completed questionnaires on trauma history including the number and severity of traumatic events experienced. Cancer-specific distress, HRQOL, and depression were also reported.Findings As hypothesized, trauma history and cancer-specific distress were negatively associated with HRQOL (all r’s > −.27). Depression emerged as a confound in the association between cancer-specific distress and HRQOL.Conclusions Retrospectively-reported trauma was linked with poorer HRQOL in lung cancer patients.Implications Interventions aimed at improving lung cancer patients’ HRQOL should consider the possible role of trauma history (both frequency and distress).
Poor breast cancer–related quality of life is associated with flattened cortisol rhythms and inflammation in breast cancer survivors and women with advanced disease. We explored the associations of cancer-specific distress (Impact of Events Scale), mood (Profile of Mood States), activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient) and cortisol (diurnal slope) circadian rhythms, and inflammation (interleukin-6) with quality of life (Functional Assessment of Cancer Therapy–Breast) among patients awaiting breast cancer surgery ( N = 57). Models were adjusted for differences in age and cancer stage. Distress and mood disturbance were significantly correlated with lower quality of life. Ethnic differences in the relationship between distress and mood disturbance with global quality of life and subscales of quality of life were observed. Actigraphic measures showed that in comparison with non-Hispanic patients, African Americans had significantly poorer activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient). Circadian disruption and inflammation were not associated with quality of life. Physiological dysregulation and associated comorbidities may take time to develop over the course of disease and treatment.
Lung cancer is the most common malignant disease worldwide, and the rapid decline in functioning due to the often-later stage diagnosis can strongly impact a patient’s health-related quality of life (HRQOL). Palliative care, with the aim of improving later-stage HRQOL, is often a main goal of treatment. Compared to other cancer types, patients with lung cancer experience the greatest amount of psychological distress during and after treatment. Prior trauma exposure, and the potentially traumatic nature of the cancer experience, can further complicate HRQOL. Mindfulness, an innate or acquired capacity for sustaining attention in the present moment with qualities of self-warmth and compassion, may serve as a protective factor that promotes well-being following a cancer diagnosis. The present study investigated the associations of trauma, HRQOL and mindfulness in a sample of lung cancer patients. It also examined the potential moderating role dispositional mindfulness may take in buffering the relationship between trauma and HRQOL. Forty-six participants diagnosed within the last five years with non-small cell lung cancer (34 females, 12 males, mean age = 61.5) were administered self-report assessments of trauma history, traumatic distress appraisal, cancer-specific distress, HRQOL and mindfulness. Hierarchical linear regression analyses were employed to investigate the relationships of interest. Primary analyses revealed that traumatic distress appraisal and cancer-specific distress were negatively associated with HRQOL. Mindfulness was negatively associated with cancer-specific distress and positively associated with HRQOL. The relationships between trauma (as measured by traumatic distress appraisal and cancer-specific distress) and HRQOL were not moderated by mindfulness. The current study supports the notion that trauma factors engender a vulnerability to having poorer HRQOL and that mindfulness may serve as a protective factor in the psychological adjustment to lung cancer and can improve quality of life. Future studies should further investigate mindfulness as both an explanatory construct and an intervention target to improve HRQOL in lung cancer patients.
Several recent reviews have evaluated evidence on the efficacy of Mindfulness-Based Stress Reduction (MBSR) among fibromyalgia sufferers, and concluded that more research should test effects on both psychological and physiological functioning. We conducted a randomized prospective trial of MBSR among female fibromyalgia patients. Effects on perceived stress, pain, sleep quality, fatigue, symptom severity, and salivary cortisol were tested in treatment (n = 51) versus wait-list control participants (n = 40) using data at baseline, post-program, and 2-month follow-up. Analyses revealed that MBSR significantly reduced perceived stress, sleep disturbance, and symptom severity, with gains maintained at follow-up. Greater home practice at follow-up was associated with reduced symptom severity. MBSR did not significantly alter pain, physical functioning, or cortisol profiles. MBSR ameliorated some of the major symptoms of fibromyalgia and reduced subjective illness burden. Further exploration of MBSR effects on physiological stress responses is warranted. These results support use of MBSR as a complementary treatment for women with fibromyalgia (ISRCTN: 34628811).
