Optimal communication associated with lower risk of acute traumatic stress after lung cancer diagnosis

Hrönn Harðardóttir*, Thor Aspelund, Jianwei Zhu, Katja Fall, Arna Hauksdóttir, Fang Fang, Donghao Lu, Christer Janson, Steinn Jónsson, Heiðdís Valdimarsdóttir, Unnur Anna Valdimarsdóttir, Hronn Hardardottir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Purpose: The aim of this study was to assess the role of the patient’s background and perceived healthcare-related factors in symptoms of acute stress after lung cancer diagnosis. Methods: The study population consisted of 89 individuals referred for diagnostic work-up at Landspitali National University Hospital in Iceland and subsequently diagnosed with lung cancer. Before diagnosis, the patients completed questionnaires on sociodemographic characteristics, pre-diagnostic distress (Hospital Anxiety and Depression Scale), social support, and resilience. At a median of 16 days after diagnosis, the patients reported symptoms of acute stress on the Impact of Event Scale-Revised (IES-R) and experience of communication and support from healthcare professionals and family during the diagnostic period. Results: Patients were on average 68 years and 52% reported high levels of post-diagnostic acute stress (IES-R > 23) while 24% reported symptoms suggestive of clinical significance (IES-R > 32). Prior history of cancer (β = 6.7, 95% CI: 0.1 to 13.3) and pre-diagnostic distress were associated with higher levels of post-diagnostic acute stress (β = 8.8, 95% CI: 2.7 to 14.9), while high educational level (β = − 7.9, 95% CI: − 14.8 to − 1.1) was associated with lower levels. Controlling for the abovementioned factors, the patients’ perception of optimal doctor-patient (β = − 9.1, 95% CI: − 14.9 to − 3.3) and family communication (β = − 8.6, 95% CI: − 14.3 to − 2.9) was inversely associated with levels of post-diagnostic acute stress after lung cancer diagnosis. Conclusions: A high proportion of patients with newly diagnosed lung cancer experience high levels of acute traumatic stress of potential clinical significance. Efforts to improve doctor-patient and family communication may mitigate the risk of these adverse symptoms.

Original languageEnglish
Pages (from-to)259-269
Number of pages11
JournalSupportive Care in Cancer
Issue number1
Early online date17 Jul 2021
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This work was supported by the Rannis Research Fund (grant number: 141667-051), the Swedish Cancer Foundation (grant number: 16 0720), the Doctoral Grant from the University of Iceland Research Fund/Eimskip University Fund 2018, and the Landspitali University Hospital Research Fund 2015.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Other keywords

  • Doctor-patient communication
  • Lung cancer diagnosis
  • Post-diagnostic acute stress
  • Posttraumatic stress disorder (PTSD)
  • Prospective cohort study
  • Lung Neoplasms
  • Diagnosis
  • Stress Disorders, Post-Traumatic
  • Physician-Patient Relations
  • Humans
  • Risk Factors
  • Lung Neoplasms/diagnosis
  • Surveys and Questionnaires
  • Communication


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