Skip to main content
Log in

Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Introduction

This qualitative study was set out to explore experiences of care provision of 60 patients diagnosed with lung cancer and a carer of their choice

Materials and methods

Participants were invited to take part in three in-depth interviews over a 6-month period. After considerable sample attrition due to worsening disease or death over the study period, 23 complete patient data sets were available for analysis. Fifteen complete carer data sets were analysed.

Results

Four key domains of need were identified: (1) the pathway to confirmation of diagnosis, (2) communication of diagnosis, treatment options and prognosis, (3) provision of co-ordinated, family-oriented care and (4) support away from acute services. Discernable shifts in patients’ needs were apparent over time within and across the four domains, illustrating a complex relationship between the categories of need experienced by patients and carers.

Discussion

Around the time of diagnosis, the priorities of patients and carers centred around their needs for information about the process of treatment and the options open to them. As time went on, they appeared to experience feelings of greater isolation and physical dependency and were particularly aware of deficiencies in the coordination of supportive care. Many patients appeared to rely on the relationship they had developed with their hospital consultant and, therefore, found it difficult to make the transition into palliative care or at least a more primary-care-led service once treatment was over.

Conclusion

Data from the study point to the importance of heightening general practitioner awareness of potential signs and symptoms of lung cancer. Findings indicate the need to evaluate the benefits to patients and carers of rapid access to diagnostic tests and results and support the establishment of effective and streamlined supportive care pathways for patients with lung cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Janssen-Heijnen M, Gatta G, Forman D, Capocaccoa R, Coebergh J, EUROCARE Working Group (1998) Variation in survival of patients with lung cancer in Europe, 1985–1989. Eur J Cancer 34(14):2191–2196

    Article  CAS  Google Scholar 

  2. Corner J, Hopkinson J, Fitzsimmons D, Barclay S, Muers M (2005) Is late diagnosis of lung cancer inevitable? Interview study of patients’ recollections of symptoms before diagnosis. Thorax 60:314–319

    Article  PubMed  CAS  Google Scholar 

  3. Montazeri A, Milroy R, Hole D, McEwen J, Gillis C (2003) How quality of life data contribute to our understanding of cancer patients’ experiences? A study of patients with lung cancer. Qual Life Res 12(2):157–166

    Article  PubMed  Google Scholar 

  4. Carlsen K, Jensen A, Jacobsen E, Krasnik M, Johansen C (2005) Psychosocial aspects of lung cancer. Lung Cancer 47:293–300

    Article  PubMed  Google Scholar 

  5. Gift A, Jablonski A, Stommel M, Given C (2004) Symptom clusters in elderly patients with lung cancer. Oncol Nurs Forum 31(2):202–212

    PubMed  Google Scholar 

  6. Hopwood P, Stephens R (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18(4):893–903

    PubMed  CAS  Google Scholar 

  7. Houts PS, Yasko JM, Kahn SB, Schelzel GW, Marconi GM (1986) Unmet psychological, social, and economic needs of persons with cancer in Pennsylvania. Cancer 58(10):2355–2361

    Article  PubMed  CAS  Google Scholar 

  8. Hill K, Amir Z, Muers M, Connolly C, Round C (2003) Do newly diagnosed lung cancer patients feel their concerns are being met? Eur J Cancer Care 12(1):35–45

    Article  CAS  Google Scholar 

  9. Krishnasamy M, Wilkie E, Haviland J (2001) Lung cancer health care needs assessment: patients’ and informal carers’ responses to a national mail questionnaire survey. Palliat Med 15(3):213–227

    Article  PubMed  CAS  Google Scholar 

  10. Bazeley P, Richards L (2000) The NVivo qualitative project book. Sage, London

    Google Scholar 

  11. Yardley S, Davis C, Sheldon F (2001) Receiving a diagnosis of lung cancer: patients’ interpretations, perceptions and perspectives. Palliat Med 15:379–386

    Article  PubMed  CAS  Google Scholar 

  12. Muers M, Holmes W, Littlewood C (1999) The challenge of improving the delivery of lung cancer care. Thorax 54:540–543

    Article  PubMed  CAS  Google Scholar 

  13. Stalhammer J, Holmberg L, Svardsudd K, Tibblin G (1998) Written communication from specialists to general practitioners in cancer care. What are their expectations and how are they met? Scand J Prim Health Care 16:154–159

    Article  Google Scholar 

  14. Munday D, Dale J, Barnett M (2002) Out of hours palliative care in the UK: perspectives from general practice and specialist services. J R Soc Med 95:28–30

    Article  PubMed  Google Scholar 

  15. Moore S, Corner J, Haviland J, Wells M, Salmon E, Normand C et al (2002) Nurse-led follow-up and conventional medical follow-up in management of patients with lung cancer: randomised trial. BMJ 325:1145–1147

    Article  PubMed  Google Scholar 

  16. London and South East Lung Cancer Forum for Nurses (2004) Guidelines on the role of the specialist nurse in supporting patients with lung cancer. Eur J Cancer Care 13:344–348

    Article  Google Scholar 

  17. Murray S, Boyd K, Worth A, Benton F, Clausen H (2002) Dying of lung cancer or cardiac failure: prospective qualitative interview study of patients and their carers in the community. BMJ 325:347–929

    Article  Google Scholar 

Download references

Acknowledgements

This study was funded by the Chief Scientist Office, Scotland. Extra transcription costs were met by the Tayside Oncology Fund. We would like to acknowledge the support of all the consultants who allowed us access to their clinics and also acted as grantholders, in particular Professor E. Rankin, Professor A. Munro, Dr. P. Brown, Professor B. Lipworth, Dr. R. Clark, Dr. J. Winter and Dr. S. Das. Thanks to Professor Jessica Corner for academic supervision and infrastructure support throughout the study period.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Meinir Krishnasamy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krishnasamy, M., Wells, M. & Wilkie, E. Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland. Support Care Cancer 15, 327–332 (2007). https://doi.org/10.1007/s00520-006-0129-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-006-0129-3

Keywords

Navigation