Introduction: Lung cancer remains among the deadliest types of cancers despite advances in treatment modalities. During the COVID-19 pandemic, lung cancer patients, a well-recognized vulnerable population, faced many difficulties in their diagnostic and treatment pathways due to significant changes in the delivery of lung cancer care. Their subsequent psychological distress and their perception of health locus of control (HLOC) still remain vague. Aim: To investigate the association between health locus of control and psychological distress among lung cancer patients during the COVID-19 pandemic in Greece. Material and Method: We prospectively studied consecutive patients diagnosed with lung cancer, at the Oncology Outpatients’ Clinic in “Sotiria” Athens’ Chest Diseases Hospital, Athens, Greece. Medical records were reviewed to collect demographics and relevant clinical information. The Health Locus of Control Scale and the Distress Thermometer were used to assess health behaviors and levels of psychological distress, respectively. Results: 160 patients with lung cancer were enrolled. Mean age was 66.2 years (age range 45 - 83 years) and 70% were male. All patients received their treatments during the pandemic. Treatment modalities included chemotherapy, immunotherapy, radiotherapy independent or in combination with the above. The most common clinical symptoms were fatigue (63.7%), breathing (48.1%) and sleep (45.0%). The most frequent emotional problems were nervousness (41.3%), anxiety (46.9%), fears (21.9%) and grief (29.4%). HLOC was positively correlated with the existence of psychological problems (p < .05) indicating a more external locus of control. Moreover, distress was positively affected by HLOC “doctors” scale dimension (p < .05) showing that lung cancer patients rely more on their doctors rather than themselves for the control of their disease. All distress thermometer (DT) subscales were positively correlated with one another (p < .001) indicating that they are interdependent. Conclusions: External HLOC is associated with psychological distress, which in turn is affected by interdependent emotional and physical problems, leading to behaviors which negatively affect lung cancer patients’ adjustment to their disease and their quality of life, which should be taken into account when treating lung cancer patients amidst unpredictable situations and frequent screening should be applied.
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