Quality of life, support and smoking in advanced lung cancer patients: a qualitative study.
BACKGROUND
Lung cancer is the most common cancer and smoking is the principal cause. Due to poor survival rates, symptom palliation and promotion of health-related quality of life (HRQoL) are primary outcomes for lung cancer patients. Given the established relationship between smoking and lung cancer, patients who have smoked may feel stigmatised or guilty after diagnosis, and more pessimistic about their illness and likely outcomes. This may have adverse implications for HRQoL.


OBJECTIVE
We explored HRQoL and support experiences among newly diagnosed patients with advanced lung cancer.


METHODS
Semistructured interviews were conducted with nine patients and analysed using interpretative phenomenological analysis.


RESULTS
Patients described the physical, emotional and social impact of disease on HRQoL. Fear of compromising their immune system and adjusting to new relationship roles had a wide-ranging effect on patients' HRQoL. Patients acknowledged links between lung cancer and smoking but some continued to smoke. They were sensitive to the opinions of medical staff about smoking especially those who continued to smoke or recently quit.


CONCLUSIONS
We conclude that staff should give clearer advice about the adverse implications of continued smoking. We discuss the potential value of diagnosis as a teachable moment for promoting smoking cessation among patients and family members.
Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK.
C
C
Rowland
Academic Unit of Clinical Oncology, University of Sheffield, Weston Park Hospital, Sheffield, UK.
S J
SJ
Danson
Department of Psychology, University of Sheffield, Sheffield, UK.
R
R
Rowe
Institute of Health and Society, Newcastle University, Newcastle, UK.
H
H
Merrick
Academic Unit of Clinical Oncology, University of Sheffield, Weston Park Hospital, Sheffield, UK.
P J
PJ
Woll
Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK.
M Q
MQ
Hatton
Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK.
J
J
Wadsley
Academic Unit of Clinical Oncology, University of Sheffield, Weston Park Hospital, Sheffield, UK.
S
S
Ellis
Academic Unit of Clinical Oncology, University of Sheffield, Weston Park Hospital, Sheffield, UK.
C
C
Crabtree
Academic Unit of Clinical Oncology, University of Sheffield, Weston Park Hospital, Sheffield, UK.
J M
JM
Horsman
Department of Psychology, University of Sheffield, Sheffield, UK.
C
C
Eiser
D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000523:psychology
Health-related quality of life; Qualitative interviews; Smoking; Support