Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study

Psychol Health. 2019 Jul;34(7):886-899. doi: 10.1080/08870446.2019.1579909. Epub 2019 Jun 3.

Abstract

Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety. Design: Semi-structured interviews of patient-caregiver dyads (N = 21), coded using NVivo Software. Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC. Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms. Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.

Keywords: Anxiety; caregivers; coping; neoplasms; qualitative research.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Anxiety / psychology*
  • Carcinoma, Non-Small-Cell Lung / psychology*
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data
  • Female
  • Humans
  • Lung Neoplasms / psychology*
  • Lung Neoplasms / secondary
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Patients / psychology*
  • Patients / statistics & numerical data
  • Qualitative Research