Factors influencing surgical choice and anxiety in patients with pulmonary nodules smaller than 8 mm.

Pulmonary nodules activities of daily living (ADLs) anxiety communication survey

Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
30 Dec 2023
Historique:
received: 05 11 2023
accepted: 13 12 2023
medline: 22 1 2024
pubmed: 22 1 2024
entrez: 22 1 2024
Statut: ppublish

Résumé

The detection of pulmonary nodules significantly impacts the lives and mental health of patients. Although the 2020 National Comprehensive Cancer Network (NCCN) guidelines recommend scheduled surveillance for nodules ≤8 mm, patients often opt to have their nodules surgically removed. A cross-sectional questionnaire was administered to patients with small pulmonary nodules who presented to a local grade 3 hospital with small pulmonary nodules and decided to receive surgery versus prescribed monitoring. The questionnaire included four aspects: (I) patient characteristics; (II) nodule-specific knowledge; (III) doctor-patient communication; and (IV) nodular-specific distress. Nodular-specific distress was measured by the Impact of Event Scale-Revised (IES-R). A total of 234 (69%) patients responded to the survey and were included in the final analysis. Poor performance in activities of daily living (ADLs), the presence of solid nodules, multifocal disease, and a family history of lung cancer were significantly associated with reported anxiety. Most notably, facilitating patient choice for surgery was the computed tomography (CT) scan results, with reference to lung nodule size and number of nodules, where concerns related to lung nodule, cancer risk, and fear of surgery or death had a significant psychological impact on patients. In this cohort of patients who elected to have their small pulmonary nodules surgically removed, we identified key factors underlying their anxiety toward guideline recommended surveillance. Our findings will be useful for clinicians when discussing treatment options with their patients.

Sections du résumé

Background UNASSIGNED
The detection of pulmonary nodules significantly impacts the lives and mental health of patients. Although the 2020 National Comprehensive Cancer Network (NCCN) guidelines recommend scheduled surveillance for nodules ≤8 mm, patients often opt to have their nodules surgically removed.
Methods UNASSIGNED
A cross-sectional questionnaire was administered to patients with small pulmonary nodules who presented to a local grade 3 hospital with small pulmonary nodules and decided to receive surgery versus prescribed monitoring. The questionnaire included four aspects: (I) patient characteristics; (II) nodule-specific knowledge; (III) doctor-patient communication; and (IV) nodular-specific distress. Nodular-specific distress was measured by the Impact of Event Scale-Revised (IES-R).
Results UNASSIGNED
A total of 234 (69%) patients responded to the survey and were included in the final analysis. Poor performance in activities of daily living (ADLs), the presence of solid nodules, multifocal disease, and a family history of lung cancer were significantly associated with reported anxiety. Most notably, facilitating patient choice for surgery was the computed tomography (CT) scan results, with reference to lung nodule size and number of nodules, where concerns related to lung nodule, cancer risk, and fear of surgery or death had a significant psychological impact on patients.
Conclusions UNASSIGNED
In this cohort of patients who elected to have their small pulmonary nodules surgically removed, we identified key factors underlying their anxiety toward guideline recommended surveillance. Our findings will be useful for clinicians when discussing treatment options with their patients.

Identifiants

pubmed: 38249895
doi: 10.21037/jtd-23-1701
pii: jtd-15-12-6889
pmc: PMC10797356
doi:

Types de publication

Journal Article

Langues

eng

Pagination

6889-6897

Informations de copyright

2023 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1701/coif). S.L. received fees for consulting and training from Olympus, Fujifilm, and Ambu. The other authors have no conflicts of interest to declare.

Auteurs

Hongbin Qiu (H)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Yingqiao Lou (Y)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Zimin Wang (Z)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Fenglai Xue (F)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Zhongxiao Chen (Z)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Congcong Xu (C)

Department of Cardiothoracic Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, China.

Pasan Witharana (P)

Department of Surgery and Cancer, Imperial College London, London, UK.

Dong Chen (D)

Department of Thoracic Surgery, Jinhua Hospital of Zhejiang University, Jinhua, China.

Kanghao Zhu (K)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Jiawei Li (J)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Baofu Chen (B)

Department of Cardiothoracic Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, China.

Satoshi Fumimoto (S)

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Osaka, Japan.

Samy Lachkar (S)

Department of Pneumology, CHU Rouen, Rouen, France.

Jimmy T Efird (JT)

VA Cooperative Studies Program Coordinating Center, Boston, MA, USA.
Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Chengchu Zhu (C)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Jianfei Shen (J)

Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Classifications MeSH