title: Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland.
abstract: BACKGROUND
  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
  
  
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Hospice in the Weald, In-patient Unit, Pembury, Tunbridge Wells, Kent, TN2 4TA, UK. kmnrc@btinternet.com
authors.forename: Meinir
authors.initials: M
authors.lastname: Krishnasamy
authors.forename: Mary
authors.initials: M
authors.lastname: Wells
authors.forename: Erna
authors.initials: E
authors.lastname: Wilkie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000628:therapy; D017028:Caregivers; D003142:Communication; D005190:Family; D005260:Female; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006701:Home Nursing; D006801:Humans; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000628:therapy; D008875:Middle Aged; D020380:Needs Assessment; D010166:Palliative Care; D011368:Professional-Family Relations; D012107:Research Design; D012606:Scotland / Q000453:epidemiology; D012944:Social Support