Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
Lincoln Institute for Rural and Coastal Health, College of Health and Science, University of Lincoln, Lincoln, UK.
BMC Cancer. 2024 Aug 2;24(1):942. doi: 10.1186/s12885-024-12705-9.
Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person's location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients' and informal carers' participation in and experience of the lung cancer care pathway.
A qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals' capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement.
The study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway.
The study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023; https://osf.io/njq48 ).
肺癌是英国第三大常见癌症，也是全球癌症死亡的主要原因。英格兰国民保健署（NHS England）优化肺癌护理的指南建议由专家团队进行管理和治疗，专家集中在一个地方，提供专门的诊断和治疗设施。然而，肺癌的诊断和治疗途径复杂且快速演变，加上劳动力的限制，使得实现这一目标具有挑战性。这项基于地点的、受行为科学启发的定性研究旨在探讨人与专家服务的相对位置的相关特征如何相互作用，从而影响他们对最佳肺癌途径的参与，并比较和对比农村、沿海和城市社区的经验。该研究还旨在生成可转化的证据，为改善肺癌患者和非正式照顾者参与和体验肺癌护理途径的患者参与干预措施提供循证设计依据。
一项定性的横断面访谈研究，纳入在招募前 6 个月内被诊断为肺癌的患者（接受手术、根治性放疗或患有晚期疾病）及其非正式照顾者。参与者将从 Barts Health NHS 信托基金和联合林肯郡医院 NHS 信托基金有目的地招募，以确保在城市和农村环境中具有多样化的样本。半结构化访谈将探讨影响个人参与其推荐的诊断和治疗途径的能力、机会和动机的因素。一个框架方法，受 COMB 模型的启发，将用于对促进和阻碍患者参与的因素进行主题分析。
该研究符合当前的政策重点，即确保无论患者居住在哪里，都能获得最佳质量的治疗和护理。所产生的证据将用于确保开发肺癌服务以满足农村、沿海和城市社区的需求。研究结果将为支持患者参与其推荐的肺癌途径的干预措施的制定提供信息。
该研究于 2023 年 8 月 4 日获得了英国国民保健署（NHS England）研究伦理委员会（编号：23/SC/0255）和英国国民保健署（NHS）健康研究管理局（IRAS ID 328531）的批准。该研究于 2023 年 10 月 16 日在开放科学框架上进行了前瞻性注册（https://osf.io/njq48 ）。
