Title : Exploring patients symptom management experiences and unmet supportive care needs during lung cancer chemotherapy: A qualitative study
Abstract:
Background: Patients with lung cancer undergoing chemotherapy commonly experience multiple concurrent symptoms that challenge effective symptom management and negatively affect quality of life. Although previous research has extensively documented symptom burden, less is known about how patients manage these symptoms in everyday life and what supportive care they perceive as lacking. Understanding these experiences is essential for developing patient-centered, nurse-led interventions that address patients' evolving needs throughout chemotherapy.
Objective: This study aimed to explore patients' symptom management experiences and unmet supportive care needs during lung cancer chemotherapy to inform the development of patient-centered, nurse-led interventions.
Methods: A qualitative descriptive study was conducted using semi-structured interviews with patients receiving chemotherapy for lung cancer at a tertiary hospital in China. Participants were recruited through purposive sampling until data saturation was achieved. Interview data were analyzed using conventional qualitative content analysis.
Results: Patients described symptom management as a dynamic and ongoing process of adaptation, during which they continuously interpreted symptom changes, adjusted self-management strategies, evaluated their effectiveness, and sought professional support when personal coping resources became insufficient. This adaptive process was shaped by the interaction of symptom burden, self-management capability, healthcare support, and evolving supportive care needs. Fatigue was consistently described as one of the most burdensome symptoms, interacting with sleep disturbance, emotional distress, appetite changes, and reduced physical functioning, thereby influencing patients' overall symptom management. Participants also highlighted unmet supportive care needs, including individualized symptom assessment, practical self-management education, timely professional guidance, psychological support, and continuous nurse-led follow-up. Collectively, these findings suggest that successful symptom management depends not only on patients' individual coping efforts but also on responsive, coordinated, and personalized nursing support delivered across the entire chemotherapy trajectory.
Conclusions: Patients' symptom management experiences extend beyond coping with individual symptoms and reflect a continuous adaptive process influenced by personal capabilities and healthcare support. These findings identify key priorities for supportive oncology nursing and provide an evidence-informed qualitative foundation for developing patient-centered, nurse-led symptom management interventions that strengthen self-management capacity and improve continuity of care during chemotherapy.
