Trends in Biomedical Research by Mieczyslaw Pokorski

Author:Mieczyslaw Pokorski
Language: eng
Format: epub
ISBN: 9783030412197
Publisher: Springer International Publishing

2 Methods

2.1 Patients and Questionnaires

There were 185 patients (mean age 62.7 ± 9.7 years) included in this survey study, with a clinically confirmed diagnosis of NSCLC. The patients were treated at the Lower Silesian Lung Center in Poland. They were grouped according to the score of the mini-Mental Adjustment to Cancer (mini-MAC) scale that we used into constructive coping strategies (n = 41), balanced coping strategies (n = 56), and destructive coping strategies (n = 88). Inclusion criteria were as follows: age >18 years; consent to participate; and comprehending the survey questions. Exclusion criteria were as follows: uncertain cancer diagnosis; coexistence of other severe chronic diseases that could interfere with the patient’s perception of health status such as other malignant tumors, mental disorders, and other conditions that could make the patient unfit to fill in surveys. Each patient underwent clinical examinations, chest X-ray, pulmonary function tests, and biochemical blood tests along with blood gas content analysis. Clinical data were retrieved from the patients’ medical files.

The mini-MAC scale is a self-reported psychometric tool, developed by Watson et al. (1994) and modified for the Polish population by Juczyński (2001). It consists of 29 items that assess four coping strategies: 1. anxious preoccupation (anxiety about the disease and seeing the disease as something alarming, uncontrollable, and threatening); 2. fighting spirit (seeing the disease as a challenge, with active efforts to seek complementary therapies, often including dancing, traveling, or exercising); 3. helplessness/hopelessness (a sense of confusion and helplessness, often entailing a withdrawal from activities, and giving up work); and 4. positive redefinition (changing one’s attitude toward life and appreciation of its value in the face of the disease). Anxious preoccupation and helplessness/hopelessness are components of the passive or destructive coping strategy, while the other two strategies are part of the active or constructive coping strategy. Each statement in the mini-MAC questionnaire is rated at a four-point scale with “1” denoting definitely disagree and “4” denoting definitely agree. The score for each coping strategy is calculated separately by adding scores from specific items; it ranges between 7 and 28 points. The higher the score, the greater is the intensity of behaviors associated with a given coping strategy.

We also used the Hospital Anxiety and Depression Scale (HADS) that consists of 14 items, 7 each related to the symptoms of anxiety (HAD-A) and depression (HAD-D). Cronbach’s alpha coefficient of the scale is 0.77 and the test–retest reliability is 0.73. The higher the score, the greater are anxiety symptoms. A score <8 points indicates lack of any mental disorder, 8–10 points to the possibility of a disorder, and >10 indicates that a disorder is highly likely to be present (Bjelland et al. 2002; Zigmond and Snaith 1983). The scale does not evaluate somatic symptoms, but it detects item bias and provides valid comparisons of patients’ well-being in clinical practice (Verdam et al. 2017).

The Zubrod score was used to assess the overall health and performance of NSCLC patients. The score runs from 0 to 5, with 0 denoting perfect health and 5 death (Oken et al.

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