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SHARING BAD NEWS: DEVELOPMENT OF AN INTERVENTION TO SUPPORT PATIENTS WITH LUNG CANCER SHARE NEWS OF THEIR CANCER DIAGNOSIS WITH FAMILY MEMBERS AND FRIENDS
  1. G Ewing1,
  2. N Ngwenya1,
  3. M Farquhar2,
  4. D Gilligan3,
  5. S Bailey3,
  6. J Benson2 and
  7. J Seymour4
  1. 1Centre for Family Research, University of Cambridge, UK
  2. 2Department of Public health and Primary Care, University of Cambridge, UK
  3. 3Cambridge University Hospitals Trust, UK
  4. 4University of Nottingham, UK

    Abstract

    Introduction Much research has focussed on breaking bad news (BBN) i.e. on how physicians communicate a cancer diagnosis to patients. There is little understanding of the subsequent process, when patients go home and share bad news (SBN) with family members/friends: a situation faced by 115 people every day in the UK who receive a lung cancer diagnosis.

    Aim(s) and method(s) To identify key components of an intervention to prepare/support people with sharing news of their lung cancer diagnosis with wider family members/friends. Stage 1: qualitative interviews with 20 patients with lung cancer and 17 family members/friends present at BBN consultations, interviews/focus groups with 41 clinicians to examine experiences with BBN and SBN. Stage 2: workshop with 6 service users, feedback to participating clinicians and interviews to explore feasible intervention strategies. Data digitally recorded, transcribed verbatim. Thematic framework analysis.

    Results Patients and family/friends found sharing bad news difficult and complex and a process that happens over time. A mismatch in perceptions of support with SBN between clinicians and patients indicated need for a pro-active and universal approach to offering support. Six core elements were identified in SBN (people to be told, timing of sharing, information to be told, responsibility for sharing, methods of telling others and reactions of those told).These core components have informed development of a supportive intervention for practice.

    Conclusion(s) Sharing bad news is a challenging process which is currently largely unsupported. An intervention to support patients with sharing news of a lung cancer diagnosis is highly relevant for palliative care.

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