Discrepancy in perception of symptoms among patients and medical staff after lung cancer surgery

Abstract Context: Patients undergoing surgery for lung cancer experience a variety of symptoms such as pain and coughing, which interfere patients’ daily function after surgery. However, there may be some differences between the perception of symptoms by medical staff and the actual situation of patients. Objectives This study aimed to investigate patient’s experiences after lung cancer surgery and analyze whether the perception of postoperative symptoms by the medical staff differed from that reported by patients. Methods Semi-structured qualitative interviews concerning in-hospital experiences were conducted from June 2018 to October 2019 in 39 patients undergoing lung cancer surgery at the Sichuan Cancer Hospital. Moreover, 22 thoracic medical staff were instructed to answer open questions about their perception of symptoms related to the lung cancer surgery. Types and frequencies of symptoms from patients and medical staff were compared. Results Thirty-nine patients were interviewed, and 22 medical staff from the Department of Thoracic Surgery were investigated. The most frequent patient-reported symptoms were pain (967 times, 39 patients, 100%), coughing (904 times, 37 patients, 94.87%), shortness of breath (491 times, 35 patients, 89.74%), disturbed sleep (412 times, 34 patients, 87.18%), and interference with walking (347 times, 36 patients, 92.31%). Of the above symptoms, four were perceived by medical staff, whereas interference with walking was replaced by fatigue. Conclusion Although the medical staff and patients had a certain consensus on main symptoms, differences in perception still exist. Medical staff need to pay more attention to postoperative interference with walking.

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Improving patient engagement, adherence, and satisfaction in lung cancer surgery with implementation of a mobile device platform for patient reported outcomes

Journal of Thoracic Disease ◽

10.21037/jtd.2020.01.23 ◽

2020 ◽

Vol 12 (11) ◽

pp. 6883-6891

Author(s):

Peter J. Kneuertz ◽

Niveditha Jagadesh ◽

Alicia Perkins ◽

Morgan Fitzgerald ◽

Susan D. Moffatt-Bruce ◽

...

Keyword(s):

Lung Cancer ◽

Mobile Device ◽

Patient Engagement ◽

Patient Reported Outcomes ◽

Lung Cancer Surgery ◽

Cancer Surgery ◽

Patient Reported

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Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial

Journal of Clinical Oncology ◽

10.1200/jco.21.01344 ◽

2022 ◽

Author(s):

Wei Dai ◽

Wenhong Feng ◽

Yuanqiang Zhang ◽

Xin Shelley Wang ◽

Yangjun Liu ◽

...

Keyword(s):

Lung Cancer ◽

Usual Care ◽

Symptom Management ◽

Intervention Group ◽

Lung Cancer Surgery ◽

Patient Reported Outcome ◽

Cancer Surgery ◽

Interquartile Range ◽

Control Group ◽

Patient Reported

PURPOSE We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery. METHODS Before surgery, patients with clinically diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score ≥ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of ≥ 4) at discharge. Per-protocol analyses were conducted. RESULTS Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median [interquartile range], 0 [0-2] v 2 [0-3]; P = .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median [interquartile range], 0 [0-0] v 0 [0-1]; P = .018). The intervention group had a lower complication rate than the control group (21.5% v 40.6%; P = .019). Surgeons spent a median of 3 minutes managing an alert. CONCLUSION PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.

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Preoperative Lung Function is Associated with Patient Reported Outcomes After Lung Cancer Surgery

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2020.09.016 ◽

2020 ◽

Author(s):

Onkar Khullar ◽

Jane Wei ◽

Kaustabh Wagh ◽

Jose Binongo ◽

Allan Pickens ◽

...

Keyword(s):

Lung Cancer ◽

Lung Function ◽

Patient Reported Outcomes ◽

Lung Cancer Surgery ◽

Cancer Surgery ◽

Patient Reported

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Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients

Journal of Clinical Nursing ◽

10.1111/jocn.12228 ◽

2013 ◽

Vol 22 (9-10) ◽

pp. 1281-1290 ◽

Cited By ~ 43

Author(s):

Shuanglan Lin ◽

Yanhan Chen ◽

Liu Yang ◽

Jianrong Zhou

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Functional Status ◽

Lung Cancer Surgery ◽

Cancer Surgery ◽

Symptom Cluster ◽

Disturbed Sleep

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Development of the patient-reported outcomes (PRO) based survival prediction model for survivors who underwent lung cancer surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e23084 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e23084-e23084

Author(s):

Jin-Ah Sim ◽

Young Ae Kim ◽

Jong Mog Lee ◽

Moon Soo Kim ◽

Jae Ill Zo ◽

...

Keyword(s):

Lung Cancer ◽

Prediction Model ◽

Patient Reported Outcomes ◽

Lung Cancer Surgery ◽

Demographic Variables ◽

Cancer Surgery ◽

Survival Prediction ◽

Clinical Variables ◽

Tertiary Teaching ◽

Patient Reported

e23084 Background: To construct a prognostic model of 5-year survival among disease-free survivors who underwent lung cancer surgery using socio-clinical and patient-reported outcomes (PRO), and to compare its predictive performance with that of a traditional model based on known clinical variables. Methods: Data on 809 survivors who underwent lung cancer surgery between 2001 and 2006 in two Korean tertiary teaching hospitals were used. The training data set was utilized to generate the prediction model and the remaining 20% was employed as a testing set to estimate the model’s accuracy. Three Cox proportional hazard regression models were constructed and compared that of 5-year survival prediction ability through the evaluation of their performance in terms of discriminative and calibration ability. The three models were constructed with: 1) only clinical and socio-demographic variables, 2) only PROs, and 3) variables from model 1 and 2 considered altogether. The performance of each 5-year survival prediction model was evaluated using C-statistics and Hosmer-Lemeshow-type χ2-statistical analyses. Results: From the validation set, the C-statistics for the model 1, 2, and 3 were 0.70 (95% confidence interval [CI], 0.67−0.73), 0.77 (95% CI, 0.74−0.80), and 0.81 (95% CI, 0.78−0.84), respectively. In this study, model 3 (including PRO and other variables together) showed the highest discriminative and calibration ability compared to others. Conclusions: The findings suggested that the PRO included model in addition to clinical and socio-demographic variables, is more accurate in the survival prediction of lung cancer survivors than models constructed with only well-known socio-clinical variables.

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