Experiences of psychosomatic symptoms and self-management strategies among patients with advanced lung cancer undergoing chemotherapy: a qualitative study based on symptom management theory.

BACKGROUND

Lung cancer is among the malignancies with the heaviest disease burden worldwide. Patients with advanced lung cancer face substantial physical and psychological challenges during chemotherapy-based treatment. Psychosomatic symptoms are important factors influencing patients' quality of life and treatment adherence. However, although the incidence of psychosomatic symptoms in patients with advanced lung cancer undergoing chemotherapy is relatively high, their identification rates remain low.

OBJECTIVES

This study guided by symptom management theory, and aims to explore from the patients' perspective, the psychosomatic symptom experiences, management strategies, outcomes and influencing factors among individuals undergoing chemotherapy for advanced lung cancer.

METHODS

A descriptive qualitative research design was employed. Using purposive sampling, semi-structured interviews were conducted with 17 patients undergoing chemotherapy for advanced lung cancer in the Department of Medical Oncology at a tertiary Grade A hospital in Yantai City between September and December 2025. Data were analyzed using directed content analysis, and themes were extracted accordingly. NVivo 15.0 software was utilized for data management and coding.

RESULTS

After organizing, analyzing, and synthesizing the interview data, four themes and twelve categories emerged from the qualitative data: symptom experiences(complex and diverse physical symptom experiences, multidimensional interaction of psychological symptom experiences, limited social roles and functional capacity); symptom management strategies(positive approach to challenges, negative responses to symptoms); symptom outcomes(persistent psychological burden and disease-related uncertainty, reconstructing psychosomatic adaptation and self-management abilities, seeking professional medical assistance and psychological support); influencing factors(individual factors, disease and treatment factors, family and social environmental factors, cultural factors).

CONCLUSION

Based on symptom management theory, this study found that patients with advanced lung cancer undergoing chemotherapy experience multidimensional and complex psychosomatic symptoms, display varying coping strategies and have diverse symptom outcomes. Their symptom management is influenced by multiple factors, including individual characteristics, environmental conditions, and disease-related aspects. Healthcare professionals should closely attend to patients' psychosomatic experiences, guide them in adopting positive coping strategies, facilitate accurate disease understanding, and promote psychological well-being. Simultaneously, identifying the relevant factors affecting symptom management and providing targeted health education can help improve long-term symptom outcomes and reduce the overall disease burden.