title: Lung cancer diagnosed following emergency admission: a mixed methods study protocol to improve understanding of patients' characteristics, needs, experiences and outcomes.
abstract: BACKGROUND
  Lung cancer is the leading cause of death from cancer in England. About 40% of patients with lung cancer are diagnosed following an emergency admission (DFEA) to hospital. DFEA is more common in women, and more likely with increasing age and deprivation. Most have advanced disease and survival is poor, but little else is known about this group. The aim of this study is to obtain a detailed understanding of the characteristics, needs, experiences and outcomes of this group.
  
  
  METHODS
  This is a single centre study with quantitative and qualitative work packages (WP). WP1 gathers basic details about all patients diagnosed with lung cancer during a 12 month period, focusing on demographics, diagnostic and treatment pathways and selected outcomes. WP2 obtains information from those patients DFEA or, when unable, their carers, about their holistic needs and experiences, using the Sheffield Profile for Assessment and Referral to Care questionnaire and selected questions from the National Cancer Patient Experience Survey. WP3 uses in-depth qualitative interviews with patients and carers to obtain detailed accounts of their symptoms, help-seeking behaviours prior to admission and subsequent experiences of care.
  
  
  CONCLUSIONS
  Relatively little is known about the experiences of lung cancer patients DFEA and this study will provide detailed information about their needs, characteristics, experiences and outcomes. It should identify areas in the diagnostic and treatment pathway where there is scope to improve the care provided to this group of patients and their carers. The findings will also inform the need for further focused research.
authors.affiliation: School of Molecular Medical Sciences, University of Nottingham, Hucknall Road, Nottingham NG5 1PB, UK ; Nottingham University Teaching Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilcock
authors.affiliation: Nottingham University Teaching Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: Vincent
authors.initials: V
authors.lastname: Crosby
authors.affiliation: Nottingham University Teaching Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Freer
authors.affiliation: Nottingham University Teaching Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Freemantle
authors.affiliation: School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Glenys
authors.initials: G
authors.lastname: Caswell
authors.affiliation: School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Seymour
keywords: Carers; Diagnosis following emergency admission; Improving patient experience; Lung cancer