Effect of early palliative care on quality of life in patients with non-small-cell lung cancer

Abstract

Background: Patients with metastatic non-small-cell lung cancer (nsclc) experience great pain and stress. Our study aimed to explore the effect of early palliative care on quality of life in patients with nsclc.

Methods: A total of 150 patients were randomly divided into two groups: control group with conventional care and study group with early palliative care. The quality of life (qol) rating scale and self-rating scale of life quality (sslq) were used to analyze the patients' quality of life. The Hospital Anxiety and Depression Scale-D/A (hads-d/a) and Patient Health Questionnaire 9 (phq-9) were used to analyze the patients' mood. Pulmonary function indexes of peak expiratory flow (pef), functional residual capacity (frc), and trachea-esophageal fistula 25% (tef 25%) were analyzed using the lung function detector.

Results: The qol and sslq scales scores of patients receiving early palliative care were significantly higher than those in the control group (p < 0.05). Moreover, the questionnaire results of the hads-d/a and phq-9 were better in patients receiving palliative care than in the control group (p < 0.05 or p < 0.01). In addition, analytical results of pulmonary function showed that the levels of pef, frc, and tef 25% in patients assigned to early palliative care were remarkably higher than those in the control group (p < 0.01 or p < 0.001).

Conclusions: These data demonstrate that early palliative care improves life quality, mood, and pulmonary function of nsclc patients, indicating that early palliative care could be used as a clinically meaningful and feasible care model for patients with metastatic nsclc.

Keywords: Palliative care; hads-d/a; non-small-cell lung cancer; phq-9; pulmonary function.

FIGURE 1

Effects of early palliative care on patients’ quality of life. One hundred fifty enrolled patients were randomly divided into two groups: the control group received conventional tumour management, and the study group received early palliative care combined with standardized tumour management. Quality of life of nsclc patients was analyzed using (A) the QOL rating scale and (B) the SSLQ rating scale. Higher scores indicate better quality of life. NSCLC = non-small-cell lung cancer; QOL = quality of life; SSLQ = self-rating scale of life quality; *p < 0.05.

FIGURE 2

Effects of palliative care on the mood of patients. One hundred fifty enrolled patients were randomly divided into two groups: the control group received conventional tumour management, and the study group received early palliative care combined with standardized tumour management. (A) HADS-D (B) HADS-A and (C) PHQ-9 were used to analyze the mood of nsclc patients. HADS-D = hospital anxiety and depression scale-D (depression); HADS-A = hospital anxiety and depression scale-A (anxiety); PHQ-9 = patient health questionnaire 9; *p < 0.05; **p < 0.01.

FIGURE 3

Effects of palliative care on pulmonary function of patients. One hundred fifty enrolled patients were randomly divided into two groups: the control group received conventional tumour management, and the study group received early palliative care combined with standardized tumour management. The three pulmonary function indices, (A) PEF, (B) FRC, and (C) TEF 25%, were measured with a lung function detector. PEF = peak expiratory flow; FRC = functional residual capacity; TEF 25% = trachea-esophageal fistula 25%; **p < 0.01; ***p < 0.001.