Development of the Japanese version of an information aid to provide accurate information on prognosis to patients with advanced non–small-cell lung cancer receiving chemotherapy: a pilot study

Abstract Background Without explicit prognostic information, patients may overestimate their life expectancy and make poor choices at the end of life. We sought to design the Japanese version of an information aid (IA) to provide accurate information on prognosis to patients with advanced non–small-cell lung cancer (NSCLC) and to assess the effects of the IA on hope, psychosocial status, and perception of curability. Methods We developed the Japanese version of an IA, which provided information on survival and cure rates as well as numerical survival estimates for patients with metastatic NSCLC receiving first-line chemotherapy. We then assessed the pre- and post-intervention effects of the IA on hope, anxiety, and perception of curability and treatment benefits. Results A total of 20 (95%) of 21 patients (65% male; median age, 72 years) completed the IA pilot test. Based on the results, scores on the Distress and Impact Thermometer screening tool for adjustment disorders and major depression tended to decrease (from 4.5 to 2.5; P = 0.204), whereas no significant changes were seen in scores for anxiety on the Japanese version of the Support Team Assessment Schedule or in scores on the Hearth Hope Index (from 41.9 to 41.5; p = 0.204). The majority of the patients (16/20, 80%) had high expectations regarding the curative effects of chemotherapy. Conclusion The Japanese version of the IA appeared to help patients with NSCLC maintain hope, and did not increase their anxiety when they were given explicit prognostic information; however, the IA did not appear to help such patients understand the goal of chemotherapy. Further research is needed to test the findings in a larger sample and measure the outcomes of explicit prognostic information on hope, psychological status, and perception of curability

Low lung diffusing capacity is associated with high cardio-ankle vascular index in patients with chronic obstructive pulmonary disease

Previous studies have demonstrated that arterial stiffness is independently associated with the severity of pulmonary emphysema observed on computed tomography (CT) in patients with chronic obstructive pulmonary disease (COPD). An inverse correlation exists between emphysema severity on CT image and lung diffusing capacity; however, the relationship between lung diffusing capacity and arterial stiffness in patients with COPD remains unclear. We retrospectively analyzed the data of 30 patients with COPD. Percent predicted diffusing capacity of the lung for carbon monoxide divided by alveolar volume (%DLco/VA) was used as an index of lung diffusing capacity. We used the Goddard score as an index of the severity of pulmonary emphysema on CT image and cardio-ankle vascular index (CAVI) as an index of arterial stiffness. CAVI was inversely correlated with %DLco/VA (r = −0.539, p = 0.002) but not correlated with Goddard score (rs = 0.236, p = 0.209). None of the other respiratory parameters investigated, including forced expiratory volume in the first second (FEV1), FEV1/forced vital capacity ratio, and percent predicted FEV1, were correlated with CAVI. In multiple regression analysis, systolic blood pressure (β = 0.404, p = 0.006), %DLco/VA (β = −0.379, p = 0.012), and modified Borg scale score for dyspnea (β = 0.304, p = 0.033) were significant predictors of CAVI. Lung diffusing capacity is a significant independent predictor of arterial stiffness in patients with COPD. The evaluation of %DLco/VA in patients with COPD might be useful for predicting high CAVI and the development of cardiovascular disease in the future

Additional file 1: of Development of the Japanese version of an information aid to provide accurate information on prognosis to patients with advanced non–small-cell lung cancer receiving chemotherapy: a pilot study

Information Aid for First-line Chemotherapy. (DOCX 42 kb