Congress Abstracts 2005

6

VALIDATING SELF-REGULATION THEORY IN LUNG CANCER. Teresa T. Goodell, PhD, RN, CNS, Oregon Health & Science University, Portland, OR.

Lung cancer kills more people worldwide than breast and prostate cancer combined, yet less clinical research is devoted to it than to these other cancers. It is among the most highly symptomatic of cancers, often detected late into disease progression. Blame by others and guilt for smoking may play a role in the perceived stigma against people with lung cancer. This stigma may influence how people with lung cancer and health care providers view the illness (illness appraisal). Effective symptom interventions are greatly needed for this population.

Self-regulation theory suggests that symptom distress is influenced by illness appraisal. Illness appraisal may contribute to symptom distress in people with lung cancer, but this relationship has not been explored. This relationship may suggest avenues for nurse-led symptom distress interventions that are cost-effective and entail minimal risk.

This is the first study to explore self-regulation theory as a basis for interventions designed to modify illness appraisal and reduce symptom distress in people with NSCLC. Symptom distress is viewed as distinct from symptom frequency and intensity in self-regulation theory, consisting of subjective emotional responses to symptoms.

The major objective was to explore relationships among selected components of illness appraisal (consequences, timeline, emotional representations, cureability/controllability, and illness coherence) and symptom distress in outpatients with non-small cell lung cancer (NSCLC). Thirty participants have completed three questionnaires: a demographic questionnaire, the Memorial Symptom Assessment Scale and the Illness Perception Questionnaire-Revised. Desired N is 50.

Preliminary analysis shows nine symptoms experienced by more than half the respondents: lack of energy, shortness of breath, cough, feeling drowsy, worrying, sexual problems, lack of appetite, feeling nervous and difficulty sleeping. Correlational analysis identified candidate variables for inclusion in a multiple regression model predicting symptom distress from the subset of high-frequency symptoms.

Of the illness appraisal dimensions, consequences resulted in the greatest change in R-sq. in the final model, although it did not reach statistical significance. Analysis will be repeated when the final sample is obtained. If illness appraisal contributes to symptom distress, as posed by self-regulation theory, nurse-led interventions could be developed to relieve distress in this highly symptomatic population.