Anxiety, depression, psychological resilience, and illness uncertainty in lung cancer patients undergoing thoracoscopic surgery: Correlations and associated factors

Table 1 Psychological symptom severity in lung cancer surgery patients

Indicators	n (%)
Anxiety	116 (39.06)
Depression	125 (42.09)
Anxiety or depression	187 (62.96)
Anxiety + depression	54 (18.18)

Table 2 Psychological resilience of lung cancer surgery patients, mean ± SD/median (interquartile range)

Indicators	Score
Tenacity (points)	30.00 (26.50-35.00)
Strength (points)	9.00 (6.00-11.00)
Optimism (points)	8.00 (6.00-10.00)
CD-RISC (points)	46.67 ± 8.11

CD-RISC: Connor-Davidson Resilience Scale.

Table 3 Mishel Uncertainty in Illness Scale domain scores for illness uncertainty, mean ± SD/median (interquartile range)

Indicators	Score
Ambiguity (points)	35.40 ± 6.18
Complexity (points)	19.09 ± 4.45
Inconsistency (points)	16.00 (14.00-19.00)
Unpredictability (points)	13.00 (10.00-16.00)
MUIS (points)	83.98 ± 9.45

MUIS: Mishel Uncertainty in Illness Scale.

Table 4 Correlations among anxiety, depression, psychological resilience, and illness uncertainty

Indicators	r	P value
SAS (points) vs CD-RISC (points)	-0.334	< 0.001
SDS (points) vs CD-RISC (points)	-0.435	< 0.001
SAS (points) vs MUIS (points)	0.457	< 0.001
SDS (points) vs MUIS (points)	0.394	< 0.001
CD-RISC (points) vs MUIS (points)	-0.321	< 0.001

Correlations are evaluated by Pearson correlation coefficients. SAS/SDS: Self-Rating Anxiety/Depression Scale; CD-RISC: Connor-Davidson Resilience Scale; MUIS: Mishel Uncertainty in Illness Scale.

Table 5 Preliminary screening of anxiety or depression-associated factors using univariate analysis, n (%)/median (interquartile range)

Indicators	Anxiety/depression (n = 187)	Non-anxiety/depression (n = 110)	χ2/Z	P value
Sex			0.046	0.830
Male	84 (44.92)	48 (43.64)
Female	103 (55.08)	62 (56.36)
Age (years)	54.00 (45.00-63.00)	52.00 (43.00-64.25)	-0.351	0.725
Preoperative hospital stay (day)	5.00 (4.00-5.00)	5.00 (4.00-6.00)	-0.547	0.584
Surgical technique			2.970	0.227
Thoracoscopic wedge resection	81 (43.32)	59 (53.64)
Thoracoscopic segmentectomy	57 (30.48)	27 (24.55)
Thoracoscopic lobectomy or pneumonectomy	49 (26.20)	24 (21.82)
Preoperative FEV1% < 70%	51 (27.27)	15 (13.64)	7.451	0.006
Tumor staging			4.548	0.033
0-I	115 (61.50)	81 (73.64)
II or above	72 (38.50)	29 (26.36)
Educational level			10.273	0.001
Senior high school or below	142 (75.94)	64 (58.18)
Junior college or above	45 (24.06)	46 (41.82)
Monthly household income (RMB)			6.032	0.014
< 15000	127 (67.91)	59 (53.64)
≥ 15000	60 (32.09)	51 (46.36)
CD-RISC (points)			6.621	0.010
< 47	102 (54.55)	43 (39.09)
≥ 47	85 (45.45)	67 (60.91)
MUIS (points)			4.994	0.025
< 84	82 (43.85)	63 (57.25)
≥ 84	105 (56.15)	47 (42.73)

FEV1%: The preoperative forced expiratory volume in one second as a percentage of the predicted value; CD-RISC: Connor-Davidson Resilience Scale; MUIS: Mishel Uncertainty in Illness Scale.

Table 6 Multivariate analysis of independent predictors of anxiety or depression

Indicators	B	Standard error	Wald	P value	Exp (B)	95%CI for EXP (B)
Preoperative FEV1% < 70%	0.855	0.337	6.420	0.011	2.351	1.214-4.556
Tumor staging	0.567	0.280	4.111	0.043	1.763	1.019-3.050
Educational level (senior high school or below = 0, junior college or above = 1)	-0.935	0.276	11.519	0.001	0.392	0.229-0.674
Monthly household income (RMB; < 15000 = 0, ≥ 15000 = 1)	-0.591	0.262	5.082	0.024	0.554	0.331-0.926
CD-RISC (points; < 47 = 0, ≥ 47 = 1)	-0.588	0.260	5.130	0.024	0.555	0.334-0.924
MUIS (points; < 84 = 0, ≥ 84 = 1)	0.623	0.261	5.695	0.017	1.864	1.118-3.109

FEV1%: The preoperative forced expiratory volume in one second as a percentage of the predicted value; CD-RISC: Connor-Davidson Resilience Scale; MUIS: Mishel Uncertainty in Illness Scale.