Abstract
There is increasing involvement of health professionals in organizing protocols to determine the impact of lung surgery on functional state and activities of daily living, with the aim of improving quality of life (QoL). The objective of this study was to investigate predictors of QoL improvement among patients undergoing parenchyma resection due to lung cancer. Prospective study, at teaching hospital of Universidade Estadual de Campinas (Unicamp). 36 patients with lung cancer diagnosis were assessed before surgery and on the 30th, 90th and 180th days after surgery. The Short-Form Health Survey (SF-36) was used as the dependent variable. The independent variables were the Hospital Anxiety and Depression (HAD) scale, a six-minute walking test (6-MWT), a visual analogue scale for pain, forced vital capacity (FVC), type of surgery and use of radiotherapy and chemotherapy. Generalized estimation equations (GEE) were utilized. The median age for these 20 men and 16 women was 55.5 +/- 13.4 years. Both FVC and 6-MWT were predictors of improvement in the physical dimensions of QoL (p = 0.011 and 0.0003, respectively), as was smaller extent of surgical resection (p = 0.04). The social component of QoL had improved by the third postoperative month (p = 0.0005). The predictors that affected QoL positively were better FVC and 6-MWT results and less extensive lung resection. Three months after the surgery, an improvement in social life was already seen.
Highlights
In 2001, lung cancer was responsible for more than one million deaths around the world, and was increasing at an overall rate of 5% per year, mainly at the expense of increases among women
Using the Generalized estimation equations (GEE), it could be seen that patients who had undergone minor pulmonary parenchyma resection presented better quality of life (QoL) on the Physical Role scale of SF-36 (p = 0.04)
Nineteen patients who had undergone chemotherapy and/or radiotherapy presented a decrease in QoL in the domains of Physical Functioning (p = 0.004), Physical Role (p = 0.024) and Vitality (p = 0.025)
Summary
In 2001, lung cancer was responsible for more than one million deaths around the world, and was increasing at an overall rate of 5% per year, mainly at the expense of increases among women. Standardized questionnaires provide an objective evaluation of several characteristics involved in QoL These questionnaires seek clear and objective answers to several questions from the multiprofessional team, relating to the effects of clinical or surgical therapy on survival and the quality of this survival.[5,6,7,8] One of the most-used QoL questionnaires is the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). It has been used in clinical research and epidemiological studies because it is easy to apply and is understood by patients.[9]
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