The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer

Abstract

This study examined the association between two primary covariates, extent of disease (ED) and performance status rating (PSR), and the outcome of psychological distress in patients with small cell carcinoma of the lung. Patients were studied at the time of entry onto one of three Cancer and Leukemia Group B (CALGB) protocols: 7781 (N = 165) and 8083 (N = 139) for limited disease; and 7782 (N = 151) for extensive disease. Besides ED (limited versus extensive), a four-point rating of PSR was obtained. Psychological distress was measured by the standardized Profile of Mood States (POMS). Gender, age, marital status, education, PSR, ED and two relevant interaction terms (PSR X ED; gender X ED) were analyzed using multiple linear and hierarchical regressions. Of the six main variables, gender and PSR had significant association with POMS total mood disturbance, a summary score for POMS emotional subscales, and most of the individual subscales. The PSR X ED interaction provided a rationale for testing a new regression model in which PSR and ED were combined into a single index of impairment. The final index resulted in five levels of physical impairment which bear an approximately linear relationship to increasing levels of distress (Overall regression, P less than 0.001). These data suggest that PSR is an important factor in modelling POMS distress at both levels of ED, and that ED becomes an important factor with poorer performance status only.

Predictors of patients' mental adjustment to cancer: patient characteristics and social support

“…Among the medical variables, performance status was the only predictor of fighting spirit. Previous studies have suggested that performance status is one of the most important medical factors affecting psychological distress (Bukberg et al, 1984;Lansky et al, 1985;Cella et al, 1987). This study revealed that measures o1 physical impairment other than cancer site were significantly associated with fighting spirit, suggesting that performance status is among the more important medical factors affecting cancer patients' perception of stress, as opposed to the type of cancer.…”

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

“…Distress has been defined as "a multifactorial, unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer, its physical symptoms, and its treatment" [1,2]. In the oncology context, distress is multifactorial, as numerous areas in a patient's life contribute to his or her experience of distress, including physical symptoms, disease severity, treatment [3,4]; physical activity level / performance status [5][6][7]; social support (for a review see [8]); and psychological factors such as optimism [9,10], coping style [11,12], and pre-morbid or current depression [13].…”

Effects of nutritional and psychological status of the patients with advanced stomach cancer on physical performance status

“…Individuals with a poor performance status have a lower tolerance for the cancer treatments [13,24] and fare worse than others with the same cancer stage and disease extent [9,26].…”