Journal de la dépression et de l'anxiété
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Factors Influencing Surgical Choice and Surgical Anxiety in Patients with Pulmonary Nodules Smaller than 8 mm

Hongbin Qiu, Yingqiao Lou, Congcong Xu, Pasan Witharana, Dong Chen, Sikai Wu, Kanghao Zhu, Jiawei Li, Baofu Chen, Jianfei Shen

Background: Detection of pulmonary nodules has a significant impact on people's lives and mental health. The 2020 NCCN guidelines recommend follow-up visit treatment for nodules ≤ 8 mm; however, many patients with small nodules choose surgery. We aimed to explore why these patients underwent surgery and the cause of their anxiety.

Methods: We cross-sectionally surveyed patients with small nodules who had undergone surgery at a local grade 3 hospital.

Results: 338 patients who responded, 234 were included in the final analysis. A total of 68.81% of patients reported clinically significant anxiety about pulmonary nodules, as measured by the IES-R. Poor performance in Activities of Daily Living (ADL) (P=0.022, 95% CI: 1.237-15.857) was associated with the highest positivity rate (92.31%). Other factors such as the presence of solid nodules (P=0.015, 95% CI: 1.26-8.335), multifocal disease (P=0.006, 95% CI: 1.317-5.373), and family history of lung cancer (P=0.048, 95% CI: 1.015-21.307) were also associated with distress.

Conclusion: Current ability to perform activities of daily living, presence of solid and multiple nodules, and family history of lung cancer make patients who choose surgery more likely to experience pain.