{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:45:49Z","timestamp":1790153149645,"version":"4.0.1"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2010,4,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Standardized questionnaires for patient-reported outcomes are generally composed of specified predetermined items, although other areas may also cause patients distress. We therefore studied reports of what was most distressing for 343 patients with inoperable lung cancer (LC) at six time points during the first year postdiagnosis and how these concerns were assessed by three quality-of-life and symptom questionnaires. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Qualitative analysis of patients' responses to the question \u201cWhat do you find most distressing at present?\u201d generated 20 categories, with 17 under the dimensions of \u201cbodily distress,\u201d \u201clife situation with LC,\u201d and \u201ciatrogenic distress.\u201d Descriptive and inferential statistical analyses were conducted. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The majority of statements reported as most distressing related to somatic and psychosocial problems, with 26% of patients reporting an overarching form of distress instead of specific problems at some time point. Twenty-seven percent reported some facet of their contact with the health care system as causing them most distress. While 55% to 59% of concerns reported as most distressing were clearly assessed by the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Core-30 and Lung Cancer Module instruments, the Memorial Symptom Assessment Scale, and the modified Distress Screening Tool, iatrogenic distress is not specifically targeted by any of the three instruments examined. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2009.23.3403","type":"journal-article","created":{"date-parts":[[2010,3,9]],"date-time":"2010-03-09T05:29:26Z","timestamp":1268112566000},"page":"1942-1949","source":"Crossref","is-referenced-by-count":65,"title":["Are the Most Distressing Concerns of Patients With Inoperable Lung Cancer Adequately Assessed? A Mixed-Methods Analysis"],"prefix":"10.1200","volume":"28","author":[{"given":"Carol","family":"Tishelman","sequence":"first","affiliation":[{"name":"From the Stockholms Sjukhem Foundation, Research and Development Unit\/Palliative Care; The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; Department of Neurobiology, Caring Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge; School of Health and Social Sciences, H\u00f6gskolan Dalarna, Falun; Department of Public Health and Clinical Medicine, Family Medicine; Ume\u00e5 Centre for Gender Studies, Research Programme..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"L\u00f6vgren","sequence":"additional","affiliation":[{"name":"From the Stockholms Sjukhem Foundation, Research and Development Unit\/Palliative Care; The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; Department of Neurobiology, Caring Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge; School of Health and Social Sciences, H\u00f6gskolan Dalarna, Falun; Department of Public Health and Clinical Medicine, Family Medicine; Ume\u00e5 Centre for Gender Studies, Research Programme..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Broberger","sequence":"additional","affiliation":[{"name":"From the Stockholms Sjukhem Foundation, Research and Development Unit\/Palliative Care; The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; Department of Neurobiology, Caring Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge; School of Health and Social Sciences, H\u00f6gskolan Dalarna, Falun; Department of Public Health and Clinical Medicine, Family Medicine; Ume\u00e5 Centre for Gender Studies, Research Programme..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Hamberg","sequence":"additional","affiliation":[{"name":"From the Stockholms Sjukhem Foundation, Research and Development Unit\/Palliative Care; The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; Department of Neurobiology, Caring Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge; School of Health and Social Sciences, H\u00f6gskolan Dalarna, Falun; Department of Public Health and Clinical Medicine, Family Medicine; Ume\u00e5 Centre for Gender Studies, Research Programme..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam A.G.","family":"Sprangers","sequence":"additional","affiliation":[{"name":"From the Stockholms Sjukhem Foundation, Research and Development Unit\/Palliative Care; The Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm; Department of Neurobiology, Caring Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge; School of Health and Social Sciences, H\u00f6gskolan Dalarna, Falun; Department of Public Health and Clinical Medicine, Family Medicine; 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