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Changes in Symptom Occurrence and Severity Before and After Lung Cancer Surgery
Trine Oksholm1, Christine Miaskowski, Steinar Solberg
1Author Affiliations: Centre for Shared Decision Making and Collaborative Care Research (Ms Oksholm); Department of Respiratory Medicine (Ms Oksholm and Dr Kongerud); Department for Thoracic and Cardiovascular Surgery (Dr Solberg); Department of Cardiothoracic Surgery (Dr Lie); and Division of Emergencies and Critical Care (Dr Rustoen), Oslo University Hospital, Norway; School of Nursing, University of California, San Francisco (Drs Miaskowski, Cooper, and Paul); and Faculty of Medicine (Dr Kongerud) and Institute of Health and Society, Department of Nursing Science (Dr Rustoen), University of Oslo, Norway.
Background:
Patients need information about the course of recovery after surgery for lung cancer, but knowledge about symptoms in this period is limited.
Objective:
The purpose of this study was to assess for changes in symptom occurrence rates and severity scores from the preoperative period to 1 month after surgery.
Methods:
Patients (n = 228) completed questionnaires before and at 1 month after surgery. McNemar tests were used to evaluate for changes over time in symptom occurrence rates and paired t tests for changes in symptom severity scores. General linear model was used to determine if select demographic and clinical characteristics were associated with the number of symptoms after surgery.
Results:
The total number of symptoms increased significantly from the preoperative (mean, 9.4) to the postoperative (mean, 13.1) assessment. Of the 11 symptoms that occurred in 50% or more of the patients 1 month after surgery, 8 increased significantly in both occurrence and severity. Four symptoms were experienced by more than 80% of the patients 1 month after surgery: shortness of breath (85.5%), lack of energy (83.8%), pain (83.8%), and feeling drowsy (82.5%).
Conclusions:
Patients experienced a high number of symptoms after lung cancer surgery. The only characteristic that was associated with a higher number of symptoms 1 month after surgery was the number of symptoms reported preoperatively.
Implications For Practice:
These findings can be used to educate patients about the normal course of postoperative recovery. Clinicians need to assess for these symptoms and develop effective interventions to improve symptom management for these patients.
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