title: Considerations in developing and delivering a non-pharmacological intervention for symptom management in lung cancer: the views of health care professionals.
abstract: BACKGROUND
  A respiratory distress symptom cluster has recently been identified in lung cancer associated with breathlessness, cough and fatigue, and the study reported here is part of a wider body of work being undertaken to develop a novel non-pharmacological intervention (NPI) for the management of this symptom cluster. The current paper reports the views of health care professionals (HCPs) involved with cancer care regarding the most appropriate ways of developing and delivering such a novel intervention.
  
  
  METHODS
  Five focus groups, supplemented with additional telephone interviews, were conducted with a range of both community- and acute-based HCPs involved in symptom management for lung cancer patients. Participants included oncologists, palliative care consultants, specialist nurses, occupational therapists and physiotherapists. The focus groups were transcribed verbatim and analysed using NVIVO to support a framework analysis approach.
  
  
  RESULTS
  The current delivery of NPIs was found to be ad hoc and varied between sites both in terms of what was delivered and by which health care professionals. The provision of NPIs within acute medical settings faced common problems concerning staffing time and space, and there was a recognition that the preference of most patients to make as few hospital visits as possible also complicated NPI teaching. Moreover, there may only be a small window of opportunity in which to effectively teach lung cancer patients a novel NPI as the period between diagnosis and the onset of severe symptoms is often short.
  
  
  CONCLUSIONS
  The participants agreed that the novel symptom management NPI should be individually personalised to the needs of each patient and be available for patients when they become receptive to it. Moreover, they agreed that the intervention would be most effective if delivered to patients individually rather than in groups, outside acute medical settings where possible and closer to patient's homes, should be delivered by an HCP rather than a trained volunteer or lay person and should involve informal carers wherever practicable.
authors.affiliation: Faculty of Health Sciences, University of Southampton, Highfield, Southampton, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Wagland
authors.forename: Jackie
authors.initials: J
authors.lastname: Ellis
authors.forename: Chris D
authors.initials: CD
authors.lastname: Bailey
authors.forename: Jemma
authors.initials: J
authors.lastname: Haines
authors.forename: Ann
authors.initials: A
authors.lastname: Caress
authors.forename: Mari Lloyd
authors.initials: ML
authors.lastname: Williams
authors.forename: Paul
authors.initials: P
authors.lastname: Lorigan
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Smith
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
authors.forename: Richard
authors.initials: R
authors.lastname: Booton
authors.forename: Karen
authors.initials: K
authors.lastname: Luker
authors.forename: Fiona
authors.initials: F
authors.lastname: Blackhall
authors.forename: Alex
authors.initials: A
authors.lastname: Molassiotis
mesh_terms: D001291:Attitude of Health Personnel; D003371:Cough / Q000209:etiology / Q000628:therapy; D004739:England; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D017144:Focus Groups; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000628:therapy; D036301:Qualitative Research; D012120:Respiration Disorders / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome