Symptom incongruence trajectories in lung cancer dyads

Karen S. Lyons, Christopher S. Lee, Jill A. Bennett, Lillian M. Nail, Erik Fromme, Shirin O. Hiatt, Aline G. Sayer

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Context There is little known about the pattern of change in patient-family member symptom incongruence across the lung cancer trajectory. Objectives This study examined trajectories of patient-family member incongruence in perceptions of patient physical function, pain severity, fatigue, and dyspnea in lung cancer dyads and explored the association with family member grief after patient death. Methods Lung cancer patients and their family members providing care (n = 109 dyads) rated patient symptoms and physical function five times over 12 months. Symptom incongruence trajectories were analyzed using multilevel modeling. Results Patient-family member incongruence did not significantly change over time, on average, except in the case of patient physical function where incongruence significantly declined. There was significant variability around trajectories of incongruence for all symptoms except fatigue. Exploratory analysis on a subsample of 22 bereaved family members found that incongruence regarding patient fatigue was associated with family member grief two months after patient death. Conclusion Findings suggest the importance of modeling symptom incongruence over time and taking a dyadic approach to the illness context to identify interventions that promote adjustment and quality of life for both patient and family member.

Original languageEnglish (US)
Pages (from-to)1031-1040
Number of pages10
JournalJournal of Pain and Symptom Management
Issue number6
StatePublished - Dec 1 2014
Externally publishedYes


  • Symptom incongruence
  • complicated grief
  • families
  • lung cancer
  • multilevel modeling

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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