Psychological Distress in Surgical Lung Cancer Patients: Trajectories, Influencing Factors and Impacts on Quality of Life.

[AIMS] To investigate psychological distress trajectories in surgical lung cancer patients and their influencing factors, and explore the impact of trajectories on quality of life (QoL).

[DESIGN] Prospective longitudinal study.

[METHODS] Data from 324 patients at a Chinese tertiary hospital were collected within 48 h of admission (T0), 3 days after surgery (T1), 2 weeks (T2), 3 months (T3), 6 months (T4) and 1 year after discharge (T5). Latent class growth models identified psychological distress trajectories, logistic regression analysed their influencing factors, and linear regression analysed the effects of psychological distress trajectories on QoL.

[RESULTS] Psychological distress peaked at T1, then decreased steadily. Three trajectories emerged: low-level stable group (Class 1, 45.06%), intermediate-level decreased group (Class 2, 39.51%) and high-level stable group (Class 3, 15.43%). Compared with Class 1, Class 3 was predicted by surgical modality, lymph node metastasis, postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy, while Class 2 was predicted by surgical modality, postoperative adjuvant therapy and self-efficacy. Furthermore, psychological distress trajectories negatively predicted QoL.

[CONCLUSIONS] Surgical lung cancer patients experience an initial increase in psychological distress, followed by a gradual decline, with three distinct trajectories. Surgical modality, lymph node metastasis, and postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy were the major influencing factors of psychological distress trajectories. Persistent distress adversely impacts QoL, underscoring the need for early, personalised psychological interventions to improve long-term outcomes.