title: Diagnosis as the First Critical Point in the Treatment Trajectory: An Exploration of Operable Lung Cancer Patients' Lived Experiences.
abstract: BACKGROUND
  Significant advances have been made in the surgical treatment of lung cancer while patient experiences with diagnosis, treatment, and rehabilitation remain only sparsely researched.
  
  
  OBJECTIVE
  The objective of this study was to investigate how the diagnosis affects the daily lives of patients with operable lung cancer in order to identify their needs for care interventions from the point of diagnosis to hospitalization.
  
  
  METHODS
  We investigated patients' lived experiences from a longitudinal perspective at 4 critical time points during the treatment trajectory; we present here the findings from the first time point, diagnosis. Data were collected through interviews conducted 7 to 10 days following diagnosis of lung cancer. Data from 19 patients are included, and the analysis is based on Ricoeur's interpretation theory. The study framework is inspired by Schutz's phenomenological sociology.
  
  
  RESULTS
  The findings are presented as themes that summarize and express the ways in which a diagnosis affects patients' daily lives: the cancer diagnosis comes as a shock, it changes everyday awareness; it presents the patient with an unfamiliar body, disturbs social relationships, forces the patient to face a new life situation, and demands one-on-one supportive care.
  
  
  CONCLUSIONS
  Diagnosis is the first critical point for patients with operable lung cancer and disrupts their daily life. Patients need psychosocial support during the period from diagnosis to surgical intervention and patient-tailored one-on-one information.
  
  
  CONCLUSIONS
  This article contributes to the knowledge base of support needs of lung cancer patients. Interventions aimed at supportive care during the period between diagnosis and surgical intervention should be researched.
authors.affiliation: Author Affiliations: Department of Thoracic Surgery, the Heart Centre, University Hospital of Copenhagen, Rigshospitalet (Mrs Missel and Dr Pedersen); Faculty of Health and Medical Sciences, University of Copenhagen (Dr Hendriksen); the Heart Center, University Hospital of Copenhagen, Rigshospitalet (Mrs Tewes); and the Faculty of Health and Medical Sciences and University Centre for Nursing and Care Research, Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen (Prof Adamsen), Denmark.
authors.forename: Malene
authors.initials: M
authors.lastname: Missel
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Pedersen
authors.forename: Carsten
authors.initials: C
authors.lastname: Hendriksen
authors.forename: Marianne
authors.initials: M
authors.lastname: Tewes
authors.forename: Lis
authors.initials: L
authors.lastname: Adamsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000379:methods; D036301:Qualitative Research; D012944:Social Support