Date of Conferral

2018

Degree

Ph.D.

School

Health Services

Advisor

Marylou Gutierrez

Abstract

Advances in lung cancer treatment among older adults require a risk-benefit analysis for health professionals, patients, and family members to assess increased survival and health-related quality of life (HRQL). The purpose of this study was to assess the effect of lung cancer treatment with surgery or tumor ablation on HRQL domains. A lung cancer quality of life model guided the study. The research design was a quantitative ancillary study in which 70 participants were recruited from those who had already consented to undergo a randomized clinical trial of lung cancer treatment. Data consisted of repeated administrations (baseline, 1- and 3-months) of the lung cancer symptom scale. Participants indicated their physical function, symptomatic distress, and overall quality of life experience on an analogue response card. Although randomization in a clinical trial ensures equal groups at baseline, self-selection and loss to follow-up in this comparative survey led to significant differences between the 2 treatment groups in age (p = .049) and average symptomatic distress (p = .007). Statistical analyses were performed using generalized estimating equations assuming a negative binomial distribution. There were no significant effects from treatment with surgery or tumor ablation on HRQL (physical symptoms, symptomatic distress, and overall quality of life experience) at 1-month (p = .7794, p = .6395, p = .9318) and 3-months (p = .2616, p = .1345, p = .5217) based on Holm-Bonferroni correction (p = .016). The findings indicate that among older adults with lung cancer there is no advantage in selecting surgery or tumor ablation in terms of effect on HRQL. The study may contribute to positive social change by providing lung cancer treatment-specific risk-benefit information affecting patient HRQL, which may be useful to providers, patients, and family members.

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