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Identifying primary concerns in patients newly diagnosed with lung cancer.

PURPOSE/OBJECTIVES
To compare illness concerns before and after surgery in patients newly diagnosed with early-stage lung cancer, and to determine whether perceived healthcare environment factors were associated with reduced concerns and cancer-related worry.


DESIGN
Participants completed a semistructured interview using the conceptual content cognitive map (3CM) method. Important concepts were identified in a spatial array representative of a cognitive map of the illness.


SETTING
A comprehensive cancer center and a Veterans Affairs medical center in the midwestern United States.


SAMPLE
34 men (n=22) and women (n=12), aged 47-83 years (X=65, SD=10), with newly diagnosed lung cancer were interviewed at the time of diagnosis and again three to four weeks after surgery.


METHODS
Content and frequency analysis and descriptive statistics were used to characterize the data. Correlation studies and paired t tests were used to determine relationships among the main study variables.


MAIN RESEARCH VARIABLES
Illness perceptions, worry, and health environment experience.


FINDINGS
Twelve primary content domains were identified pre- and postoperatively (seven negative and five positive). Cancer-related worry was related to negative content and to fears both before and after surgery. Positive health environment perceptions were related to positive content after surgery.


CONCLUSIONS
The findings demonstrate important areas of concern that can be targeted to reduce psychological distress and promote adaptation.


IMPLICATIONS FOR NURSING
The willingness of nurses to identify concerns, assist patients to participate in care, and identify strategies to manage unresolved issues early in the treatment trajectory is integral to optimize long-term adjustment.