Characterization of multidimensional dyspnea in advanced lung cancer with moderate to severe dyspnea-related functional impairment: a latent profile analysis.

PURPOSE: Dyspnea impacts most patients with advanced lung cancer. However, research on dyspnea has been limited by using unidimensional self-report measures despite its multidimensional nature (sensory-perceptual experience, affective distress, and functional impact), which requires a comprehensive evaluation. To identify distinct patient profiles of dyspnea presentation and evaluate differences in demographic, clinical characteristics, and patient-reported outcomes (i.e., functional impairment, quality of life, co-occurring symptoms, and self-efficacy).

METHODS

A cross-sectional, secondary analysis of 247 patients with advanced lung cancer reporting moderate-to-severe dyspnea was conducted using baseline data from a randomized controlled trial testing a behavioral intervention for dyspnea. The patient profiles of dyspnea were identified using latent profile analysis of the Cancer Dyspnea Scale. Differences among the profiles were assessed through parametric and non-parametric methods.

RESULTS

Four-class solutions were identified: All Mild (A-Mild: 53%), Moderate Effort and Discomfort & Mild Anxiety (Moderate ED & Mild A: 25.9%), All Moderate (A-Moderate: 16.6%), and All Severe (A-Severe: 4.5%) dyspnea profiles. No significant differences were found among demographic and clinical variables across the profiles. Compared to the A-Mild profile, the other three profiles reported more significant functional impairment due to dyspnea, increased levels of depression, anxiety, and fatigue, and reduced quality of life. The A-Severe profile exhibited lower self-efficacy than the Moderate ED & Mild A and the A-Moderate profiles.

CONCLUSION

Our findings highlight the multidimensional nature of dyspnea, which results in distinct patient presentations. Clinicians can create targeted interventions tailored to individual needs by classifying dyspnea symptom profiles.