Receiving a diagnosis of lung cancer: patients' interpretations, perceptions and perspectives

Lung cancer has a higher incidence than any other type of cancer and more t han 80% of sufferers die within a year of diagnosis. An important aspect of caring for cancer patients is the breaking of bad news, something that mos t doctors admit to having difficulty with. Only a few publications on this issue adopt the patients' perspective. This study aimed to document patient s' views on delivery of lung cancer diagnoses, their attitudes to methods u sed and ideas for improvement. Patients were selected from medical, surgical and general practitioner clin ics to provide insight into patients' perceptions of care in different envi ronments. Those who gave informed consent completed a taped semi-structured interview. Transcripts were analysed qualitatively using a phenomenologica l approach. Recruitment was stopped when saturation was reached: no new the mes were being identified. A summary of results was sent to patients, whene ver possible, for their comment. An independent researcher coded four trans cripts to establish the degree of inter-rater reliability. Thirteen patients were recruited. There were five key areas: communication (including the use of words such as 'tumour' and 'growth'), family/communit y issues, reaction to diagnosis, views on treatment and prognosis (all of w hich were very variable), and suggested improvements (e.g. a clearer explan ation of the experience of bronchoscopy in the patient information leaflet, PIL). Inter-rater reliability was good. The PIL is being revised. Factors including family situation and personal experience of illness vary greatly and yet they influence patients' reactions to receiving a diagnosis of lung cancer, their interpretation of this and their attitudes to the il lness and treatment. These findings underline the need to continue to devel op lung cancer services that can provide quality care tailored to each pati ent.