Longitudinal Trajectories and Predictors of Supportive Care Needs After Lung Cancer Surgery: A Prospective Cohort Study

Abstract

AIMS: To explore the trajectories of supportive care needs and identify influencing factors in lung cancer surgical patients. DESIGN: Prospective cohort study. METHODS: Data from 287 patients at a Chinese tertiary hospital were collected at admission (T0), 2 weeks post-surgery (T1), 3 months (T2), 6 months (T3) and 1 year post-surgery (T4). Latent class growth models were used to identify supportive care need trajectories, and logistic regression was used to analyse influencing factors. RESULTS: Three trajectories emerged: Sustained High Needs Group (C1, 10.8%), Moderate Gradual Declining Group (C2, 56.4%), High-Rapid Decline-Rebound Group (C3, 32.8%). Compared with C2, C1 membership was positively associated with no regular exercise, severe baseline symptoms, and adjuvant therapy; C3 membership was positively associated with segmentectomy, no regular exercise, and high social support but inversely associated with civil servant or professional status. CONCLUSION: Our study identified heterogeneity in the trajectories of supportive care needs among lung cancer surgery patients. Regular exercise, symptom burden, adjuvant therapy, segmentectomy, social support and occupation were associated with these trajectories. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses may incorporate dynamic, trajectory-informed assessment into postoperative follow-up. The associated factors identified in this study may provide practical cues for earlier recognition of patients who may benefit from closer monitoring and anticipatory supportive care planning. This approach may be particularly relevant for patients with factors associated with persistent high needs or late rebound trajectories. IMPACT: Provides longitudinal insights into the heterogeneous evolution of supportive care needs from preoperative to 1-year post-surgery. Identifies three distinct supportive care needs trajectory patterns and their associated sociodemographic and clinical factors. Offers practical cues for identifying patients who may benefit from closer follow-up and for informing dynamic, trajectory-informed supportive care planning. REPORTING METHOD: This study adhered to the STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: None.