The utility of structure-process-outcome informed psychosocial nursing for lung cancer patients with brain metastases and anxiety

  • Yu Xiang Nursing Department, Hinggan People’s Hospital Ulanhot, Nei Monggol Autonomous Region 137400, China
  • Lingling Li Nursing Department, Hinggan People’s Hospital Ulanhot, Nei Monggol Autonomous Region 137400, China
  • Zhuo Liu * Nursing Department, Hinggan People’s Hospital Ulanhot, Nei Monggol Autonomous Region 137400, China
Article ID: 4107
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Keywords: Structural-process-outcome; three-dimensional quality analysis; psychological support; lung cancer brain metastasis; anxiety

Abstract

AIM: To investigate the application value of psychological support based on the Structural-Process-Outcome three-dimensional quality analysis framework for patients with lung cancer brain metastasis and anxiety. Methods: Using the random number table method, 55 patients with lung cancer brain metastasis admitted to Xing’an League People’s Hospital from January 2020 to December 2023 were randomly divided into an observation group (28 cases) and a control group (27 cases). The control group received routine continuous nursing intervention measures; the observation group, in addition to the control group’s measures, received psychological support under the framework of the Structural-Process-Outcome three-dimensional quality analysis. Both groups of patients were followed up for 20 weeks. The differences in psychological state scores, quality of life levels, and nursing satisfaction between the two groups before and after nursing intervention were compared. Results: After 20 weeks of nursing intervention, the GAD-7 and SPBS scores in the emotional, physical, and economic dimensions of the observation group were lower than those of the control group (P < 0.05), and the EORTC QLQ-C30 scores in the physical, role, emotional, cognitive, and social functional domains were higher than those of the control group (P < 0.05), while the fatigue, pain, and nausea and vomiting symptom domains were lower than those of the control group (P < 0.05). The nursing intervention satisfaction was 100.00%, higher than the control group’s 81.48% (P < 0.05). Conclusion: Psychological support, guided by the structural-process-outcome three-dimensional quality analysis framework, can effectively improve the psychological well-being and quality of life in patients with lung cancer brain metastasis and anxiety. Moreover, it significantly enhances nursing satisfaction, underscoring its clinical value

Published
2026-01-14
How to Cite
Xiang, Y., Li, L., & Liu, Z. (2026). The utility of structure-process-outcome informed psychosocial nursing for lung cancer patients with brain metastases and anxiety. Psycho-Oncologie, 20(1), 4107. https://doi.org/10.18282/po4107
Section
Article

References

1. Pușcașu A, Moinard-Butot F, Nannini S, et al. Brain Metastases as Inaugural Sign of Non-Small Cell Lung Carcinoma: Case Series and Review of Literature. Cancers. 2024; 16(17): 3105. doi: 10.3390/cancers16173105

2. Tsakonas G, Ekman S, Koulouris A, et al. Safety and efficacy of immune checkpoint blockade in patients with advanced nonsmall cell lung cancer and brain metastasis. International Journal of Cancer. 2023; 153(9): 1556–1567. doi: 10.1002/ijc.34628

3. Ferraro E, Seidman AD. Breast Cancer Brain Metastases: Achilles’ Heel in Breast Cancer Patients’ Care. Cancer Treatment Research. 2023; 188: 283–302. doi: 10.1007/978-3-031-33602-7_11

4. Ilic I, Potthoff AL, Borger V, et al. Bone Mineral Density as an Individual Prognostic Biomarker in Patients with Surgically-Treated Brain Metastasis from Lung Cancer (NSCLC). Cancers. 2022; 14(19): 4633. doi: 10.3390/cancers14194633

5. Sperduto PW, De B, Li J, et al. Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors. International Journal of Radiation Oncology Biology Physics. 2022; 114(1): 60–74. doi: 10.1016/j.ijrobp.2022.03.020

6. Sudmeier L, Tian S, Higgins KA. Multidisciplinary Management of Brain Metastases from Non-Small Cell Lung Cancer in the Era of Immunotherapy. Current Treatment Options in Oncology. 2021; 22(9). doi: 10.1007/s11864-021-00871-y

7. Hendriks LEL, Remon J, Menis J, et al. Is there any opportunity for immune checkpoint inhibitor therapy in non-small cell lung cancer patients with brain metastases? Translational Lung Cancer Research. 2021; 10(6): 2868–2875. doi: 10.21037/tlcr-20-343

8. Gjyshi O, Lin SH, Pezzi TA, et al. Care Patterns for Stereotactic Radiosurgery in Small Cell Lung Cancer Brain Metastases. Clinical Lung Cancer. 2022; 23(2): 185–190. doi: 10.1016/j.cllc.2021.07.003

9. Nieder C, Aanes SG, Stanisavljevic L, et al. Development of brain metastases in patients managed with non-curative thoracic radiotherapy for stage II/III non-small cell lung cancer. Discover Oncology. 2024; 15(1). doi: 10.1007/s12672-024-01358-6

10. Jiang S, Liang H, Liu Z, et al. The Impact of Anlotinib on Brain Metastases of Non-Small Cell Lung Cancer: Post Hoc Analysis of a Phase III Randomized Control Trial (ALTER0303). The Oncologist. 2020; 25(5): e870–e874. doi: 10.1634/theoncologist.2019-0838

11. Eggen AC, Reyners AKL, Shen G, et al. Death Anxiety in Patients with Metastatic Non-Small Cell Lung Cancer With and Without Brain Metastases. Journal of Pain and Symptom Management. 2020; 60(2): 422–429.e1. doi: 10.1016/j.jpainsymman.2020.02.023

12. Marafi F, Esmail AA, Alfeeli MA, et al. 68Ga-Trivehexin PET/CT in Metastatic Non–Small Cell Lung Cancer to the Brain. Clinical Nuclear Medicine. 2024; 49(10): 971–972. doi: 10.1097/rlu.0000000000005406

13. Dmukauskas M, Cioffi G, Waite KA, et al. Sex Difference in Disease-Related Adverse Events Post-Diagnosis of Lung Cancer Brain Metastases in Medicare Individuals ≥ 66 Years of Age. Cancers. 2024; 16(17): 2986. doi: 10.3390/cancers16172986

14. Zhu J, Zou L, Xie X, et al. 2.5D deep learning based on multi-parameter MRI to differentiate primary lung cancer pathological subtypes in patients with brain metastases. European Journal of Radiology. 2024; 180: 111712. doi: 10.1016/j.ejrad.2024.111712

15. Schmid S, Garcia M, Zhan L, et al. Outcomes with non-small cell lung cancer and brain-only metastasis. Heliyon. 2024; 10(17): e37082. doi: 10.1016/j.heliyon.2024.e37082

16. Winslow N, Boyle J, Miller W, et al. Development of brain metastases in non-small-cell lung cancer: high-risk features. CNS oncology. 2024; 13 (1): 2395804. doi: 10.1080/20450907.2024.2395804

17. Yamamoto M, Serizawa T, Sato Y, et al. Validity test of small cell lung cancer (SCLC) graded prognostic assessment and proposal of a new index for patients with brain metastases from SCLC. Clinical and Translational Radiation Oncology. 2024; 48: 100820. doi: 10.1016/j.ctro.2024.100820

18. Popov P, Steindl A, Wolff L, et al. Clinical characteristics, treatment, and outcome of patients with large cell neuroendocrine carcinoma of the lung and brain metastases – data from a tertiary care center. Clinical & Experimental Metastasis. 2023; 41(1): 25–32. doi: 10.1007/s10585-023-10250-6

19. Chelariu-Raicu A, Piha-Paul SA, Chavez-MacGregor M, et al. Multidisciplinary Care of a Large Brain Metastasis in a Patient with Hormone-Receptor-Positive Breast Cancer with Ataxia-Telangiectasia Mutation. Journal of Immunotherapy and Precision Oncology. 2023; 6(3): 158–161. doi: 10.36401/jipo-22-33

20. Rusthoven CG, Brown PD, Robin TP. Deferring a Change in the Standard of Care for Small Cell Lung Cancer Brain Metastases—Reply. JAMA Oncology. 2021; 7(1): 135. doi: 10.1001/jamaoncol.2020.5473

21. Leclair N, Calafiore R, Wu Q, et al. Application of targeted genome sequencing to brain metastasis from non-small cell lung carcinoma: Case report. Neurochirurgie. 2020; 66(6): 477–483. doi: 10.1016/j.neuchi.2020.09.010

22. Sharma A, Mrugala MM. Supportive care for patients with brain metastases from lung cancer. Journal of Thoracic Disease. 2021; 13(5): 3258–3268. doi: 10.21037/jtd-2019-rbmlc-11

23. Sas-Korczynska B, Rucinska M. WBRT for brain metastases from non-small cell lung cancer: for whom and when?—Contemporary point of view. Journal of Thoracic Disease. 2021; 13(5): 3246–3257. doi: 10.21037/jtd-2019-rbmlc-06

24. Socha J, Rychter A, Kepka L. Management of brain metastases in elderly patients with lung cancer. Journal of Thoracic Disease. 2021; 13(5): 3295–3307. doi: 10.21037/jtd-2019-rbmlc-05

25. Steindl A, Yadavalli S, Gruber K, et al. Neurological symptom burden impacts survival prognosis in patients with newly diagnosed non–small cell lung cancer brain metastases. Cancer. 2020; 126(19): 4341–4352. doi: 10.1002/cncr.33085