Illness Perception Profiles and Psychological and Physical Symptoms in Newly Diagnosed Advanced Non-Small Cell Lung Cancer

Objective: Of all cancers, advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden on mental and physical health-related quality of life (HRQoL). Patients' subjective beliefs about their cancer (i.e., illness perceptions) may influence coping responses and treatment decisions and affect health. To identify cognitive and emotional perceptions and their association with patient characteristics and illness circumstances, the relationship between illness perception schemas and psychological and physical responses and symptoms were studied. Method: Patients newly diagnosed with stage IV NSCLC (N = 186) enrolled in a prospective cohort study (NCT03199651) completed measures of illness perceptions; anxiety, depression, and physical symptoms; and health status. Latent profile analysis identified illness perception profiles. Hierarchical linear regressions tested profile assignment as a correlate of responses and symptoms. Results: A three-profile solution was optimal. Patients with a struggling profile (n = 83; 45%) reported the most negative perceptions; patients with a coping profile (n = 41; 22%) reported relatively positive perceptions; and patients with a coping but concerned profile (n = 62; 33%) endorsed high illness concern but relatively positive perceptions otherwise. Patients with a struggling profile reported the highest levels of anxiety and depression symptoms, overall physical symptoms, cough, dyspnea, and pain, and the poorest self-rated health. Conclusions: New data add to the clinical portrayal of patients coping with NSCLC since the availability of new therapies and survival improvements. Other disease groups have reported a predominance of positive perceptions, rather than ones of significant cognitive and emotional struggles found here. Illness perception data may provide content-rich resources for intervention tailoring.

Automated summary

Patients with advanced nonsmall cell lung cancer (NSCLC) experience the highest burden on their mental and physical health-related quality of life (HRQoL). Their subjective beliefs about their cancer, known as illness perceptions, can influence their coping responses and treatment decisions, as well as their overall health. This study examines the relationship between illness perception schemas and psychological and physical responses and symptoms in newly diagnosed stage IV NSCLC patients. The findings reveal three distinct illness perception profiles and demonstrate the significant impact of these profiles on anxiety, depression, physical symptoms, and overall health of the patients. The results contribute to our understanding of how patients cope with NSCLC and provide valuable information for tailoring interventions to improve patient outcomes.