Grendarova Petra, Yannitsos Demetra, Ahmed Sadia, Santana Maria, Barbera Lisa
Department of Oncology, University of Calgary, Calgary, Canada.
BC Cancer, Victoria, Canada.
Support Care Cancer. 2024 Dec 23;33(1):51. doi: 10.1007/s00520-024-09103-z.
Lung cancer remains one of the most diagnosed cancers in Canada and continues to be the leading cause of cancer deaths in Canada, responsible for 25% of all cancer deaths. Prior studies consistently report poor experiences of people with lung cancers. The study purpose was to explore the reasons for consistently poorer reported experience of people with lung cancer compared to people with gastrointestinal cancers, who previously have reported positive cancer care experiences within the same context, and to better understand key differences that influence patient experience.
This qualitative study used semi-structured interviews of people living with lung cancer (LC) and gastrointestinal cancers (GIC) undergoing radiotherapy at a tertiary cancer centre. Thematic content analysis was conducted to analyse interview transcripts. A person-centred care framework was used to guide the development of the interview guide and data analysis.
We interviewed 16 participants (10 LC and 6 GIC). Participants with LC reported poor experience leading to and at the time of their cancer diagnosis, including delays in their diagnosis and anxiety related to their diagnosis. Most participants in both groups reported severe symptoms prior to their radiotherapy. However, the symptoms of people living with LC further worsened during the radiation therapy with the addition of treatment side effects, while the symptoms of people living with GIC were better controlled during treatment. Participants living with LC noted poor communication, gaps in coordination and uncertainty. They acknowledged awareness of support services and other resources, but they reported no interest in accessing them.
This study identified gaps in patient experience of people living with LC compared to GIC and proposed ideas for quality improvement projects, including expediting the diagnosis process, enhancing communication with patients around their lung cancer diagnosis, improved symptom management, and timing of supportive care services.
肺癌仍是加拿大诊断率最高的癌症之一，并且一直是加拿大癌症死亡的主要原因，占所有癌症死亡人数的25%。先前的研究一致报告肺癌患者的体验不佳。本研究的目的是探讨与胃肠道癌症患者相比，肺癌患者报告的体验持续较差的原因，胃肠道癌症患者此前在相同背景下报告了积极的癌症护理体验，并更好地了解影响患者体验的关键差异。
这项定性研究采用了对在三级癌症中心接受放疗的肺癌（LC）和胃肠道癌症（GIC）患者进行半结构化访谈的方法。对访谈记录进行了主题内容分析。采用以患者为中心的护理框架来指导访谈指南的制定和数据分析。
我们采访了16名参与者（10名肺癌患者和6名胃肠道癌症患者）。肺癌患者报告在癌症诊断前及诊断时体验不佳，包括诊断延迟和与诊断相关的焦虑。两组中的大多数参与者在放疗前都报告有严重症状。然而，肺癌患者的症状在放疗期间因治疗副作用而进一步恶化，而胃肠道癌症患者的症状在治疗期间得到了更好的控制。肺癌患者指出沟通不畅、协调存在差距和不确定性。他们承认知晓支持服务和其他资源，但表示对获取这些资源不感兴趣。
本研究确定了肺癌患者与胃肠道癌症患者在患者体验方面的差距，并提出了质量改进项目的想法，包括加快诊断过程、加强围绕肺癌诊断与患者的沟通、改善症状管理以及支持性护理服务的时机。
