Exploring psychological distress among lung cancer patients through the stress system model

Lung cancer, a leading cause of cancer-related mortality globally, often leads to anxiety, fear and other psychological distress due to its poor prognosis, treatment challenges, and financial burden. Prolonged distress may progress to depression or other mental health disorders, adversely affecting patients' quality of life and treatment outcomes. This study examines the prevalence and determinants of psychological distress in lung cancer patients, offering a theoretical basis for timely clinical interventions. This cross-sectional study applied the stress system model to analyze 435 conveniently sampled lung cancer patients in three Chinese tertiary hospitals from September 2023 to February 2024. Data were collected using the Distress Thermometer (DT), Medical Coping Modes Questionnaire (MCMQ), Brief Illness Perception Questionnaire (BIPQ), Edmonton Symptom Assessment Scale (ESAS), Perceived Social Support Scale (PSSS), and Type D Personality Scale (DS14). Statistical analysis, conducted with SPSS 25.0, utilized univariate, correlation, and binary logistic regression analyses to systematically explore the interrelationships and influence mechanisms of these factors on psychological distress from a holistic stress system model perspective. Among 435 lung cancer patients, 52.87% experienced psychological distress (DT = 4.24 ± 2.356). Significant risk factors (P < 0.05) included age, occupational status, family monthly income, payment method, avoidance coping style, symptoms and type D personality. As the detection rate of psychological distress in lung cancer patients is high, clinical staff should dynamically observe the psychological changes of lung cancer patients, do a good job in screening and stratified management of psychological distress, and provide interpersonal psychological guidance to establish a positive mindset, so as to reduce the negative emotions of patients, and to improve the quality of life of patients' health-related issues.