Illness Perceptions and Quality of Life in Patients with Non-Small-Cell Lung Cancer: A 3-Month Follow-Up Pilot Study.

PURPOSE: Examine illness perceptions, functional health and quality of life of lung cancer patients throughout chemotherapy treatment. PATIENTS AND METHODS: Longitudinal design with baseline measure 12 days after the first chemotherapy and follow-up measure 3 months later, where illness perceptions (BIPQ), functional health, and quality of life (EORTC QLQ-C-30) were measured. A total of 21 patients with non-small-cell lung cancer took part. Non-parametric testing was performed given the pilot nature of the study and the associated relatively small sample size. RESULTS: Small to medium changes in illness perceptions and functional health between the two measurement points were detected, with both becoming more positive. More negative illness perceptions at the beginning of the treatment were associated with less functioning and lower quality of life at both beginning and end of treatment. CONCLUSION: Addressing illness perceptions seems a clinically relevant approach in improving functioning and quality of life of patients with non-small-cell lung cancer.

Trends in diagnostic methods and treatment of latent tuberculosis infection in a tertiary care center from 2000 to 2017.

Screening for latent tuberculosis infection (LTBI) is indicated before immunosuppressive therapies but is complicated by lack of a gold standard and limited by, e.g., immunosuppression. This study aimed to investigate a series of patients diagnosed with LTBI during screening before immunosuppressive therapy, describing how the use of diagnostic tests and treatment evolved over time. This retrospective cohort study included all individuals diagnosed with LTBI during screening before intended immunosuppressive therapy in a tertiary care hospital between January 2000 and December 2017. Evidence for LTBI, including history, tuberculin skin test (TST), QuantiFERON (QFT) result and suggestive lesions on chest radiography (CXR), and CT scan if available, was analyzed. The study included 295 individuals with LTBI, with median follow-up of 3.8 years (IQR 1.7-7.4 years). During screening, TST, QFT, and CXR were positive in 80.8%, 53.4%, and 22.7%, respectively. Chest CT revealed lesions associated with past tuberculosis infection in around 70%, significantly more frequent than CXR. In patients diagnosed with LTBI, we observed that the use of TST declined over time whereas the use of QFT increased, and that isoniazid was replaced with rifampicin as preferential treatment. Preventive treatment was started in 82.3%, of whom 88.6% completed treatment. During follow-up, no individuals developed active tuberculosis. The diagnosis of LTBI was based on history, TST, QFT, and/or CXR in nearly every possible combination, but mostly on TST and QFT. The most striking trends were the decreased use of TST, increased use of QFT, and the replacement of isoniazid with rifampicin for treatment.

We're in this together: Patients', caregivers' and health care providers' illness perceptions about non-small-cell lung cancer (NSCLC).

This study reviews empirical studies in the area of illness perceptions in patients with non-small-cell lung cancer (NSCLC). Beliefs about the illness and its consequences, including its medical management, are part of the review. Also, the relatively small research area of perceptions and views about patients with NSCLC of caregivers and health care providers is reviewed. Given our earlier review of the topic in this Journal [5], we now report on papers published after that 2011 publication. 38 papers were identified, a quite major increase in published research compared to the 15 papers in our previous publication (2011 and earlier). Most papers report on psychosocial concepts that determine responses to the illness and its treatment. Increasingly, reactions of caregivers and health care providers are studied. These last two categories of respondents perceive the psychosocial consequences of NSCLC as more severe than the patients themselves. Psychosocial variables appear to be stronger predictors of psychological distress and reduced quality of life than sociodemographic or clinical variables. These results are instrumental in the developing field of psychosocial interventions for patients with non-small-cell lung cancer and their caregivers, which may also be helpful for health care providers. Suggestions for research and clinical implications are presented.