Inhospital mental strain of patients with lung cancer

Objectives: To measure mental strain, illness perception and health related quality of life (HRQL) in patients before and after lung surgery Methods: 70 patients (m=58.2±14.1 years) filled in questionnaires to measure anxiety and depression (Hospital Anxiety and Depression Scale), illness perception (Illness Perception Questionnaire), and HRQL (SF-36) one day before and one week after thoracotomy or video-assisted thoracoscopic surgery (VATS). 37 patients with a malignant lung tumor were compared with 33 patients with benign lung disease. Results: 41% had elevated anxiety and 37% elevated depression scores before intervention and 40% and 36% one week after the intervention, respectively. There was no difference between patients with malignant and benign disease. Analysis of variance (ANOVA) revealed that patients with a malignant tumor had more depressive symptoms (p=0.01). Anxiety increased in patients with lung cancer during our study period but decreased in patients with benign lung disease (p=0.05). HRQL worsened after surgical intervention irrespective of kind of disease, the physical components in particular (p<0.001). Lung cancer patients perceive their illness more unpredictably (p=0.008) and mentally more disturbing (p=.002). Conclusions: Many patients had elevated anxiety and depression scores prior to thoracic surgical intervention but patients with lung cancer report more depressive symptoms. Mental strain is pronounced after intervention in patients with malignant disease. This could be a result of absolute certainty of diagnoses through the intervention and their fear of dying. Because of the high burden of mental strain psychological support should be available for these patients.