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WHAT DO WE KNOW ABOUT THE END-OF-LIFE DECISION-MAKING EXPERIENCES OF PATIENTS WITH ADVANCED LUNG CANCER?
  1. A Roulston
  1. Queen's University Belfast, N. Ireland

    Abstract

    Introduction Lung cancer is an unforgiving illness with most patients being diagnosed in the advanced stages of disease. How much do we really know about the range of end-of-life care decisions that patients encounter?

    Aim(s) and method(s) To explore end-of-life care decision-making by patients diagnosed with advanced lung cancer known to a community palliative care team in Northern Ireland.

    Qualitative data were obtained during two individual interviews (mean duration 48 minutes) with 12 community patients diagnosed with advanced lung cancer. Llewellyn-Thomas' decision-making framework informed data collection and data were analysed using Interpretative Phenomenological Analysis and narrative analysis.

    Results Emergent themes mirrored an illness journey. (1) Beginnings: There's something not right, bad news, emotional responses and no way back; (2) Middles: Treatment decision-making, impact of treatment on quality of life and impact of illness on self, social relations and engagement with the physical world; (3) Endings: Preferred priorities for care, a good death, legacy, coping patterns and funeral wishes. Three cross-cutting themes were common: preciousness of time; importance of skilful communication, and maintenance of hope.

    Conclusion(s) This study offers insight into patients' experiences of living with advanced lung cancer, their daily navigation of decisions that surpassed our assumptions, and patient expectations of professionals. Despite knowing their inevitable fate, findings highlighted the importance of maintaining hope and exploring futures.

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