title: Sharing news of a lung cancer diagnosis with adult family members and friends: a qualitative study to inform a supportive intervention.
abstract: OBJECTIVE
  Extensive research exists on breaking bad news by clinicians. This study examines perspectives of patients and those accompanying them at diagnosis-giving of subsequently sharing news of lung cancer with adult family/friends, and views of healthcare professionals, to inform development of a supportive intervention.
  
  
  METHODS
  Qualitative interviews with 20 patients, 17 accompanying persons; focus groups and interviews with 27 healthcare professionals from four Thoracic Oncology Units. Intervention development workshops with 24 healthcare professionals and six service users with experience of sharing a cancer diagnosis. Framework thematic analysis.
  
  
  RESULTS
  Patients and accompanying persons shared news of lung cancer whilst coming to terms with the diagnosis. They recalled general support from healthcare professionals but not support with sharing bad news. Six elements were identified providing a framework for a potential intervention: 1-people to be told, 2-information to be shared, 3-timing of sharing, 4-responsibility for sharing, 5-methods of telling others and 6-reactions of those told.
  
  
  CONCLUSIONS
  This study identifies the challenge of sharing bad news and a potential framework to guide delivery of a supportive intervention tailored to individual needs of patients.
  
  
  CONCLUSIONS
  The identified framework could extend the portfolio of guidance on communication in cancer and potentially in other life-limiting conditions.
authors.affiliation: Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK. Electronic address: ge200@cam.ac.uk.
authors.forename: Gail
authors.initials: G
authors.lastname: Ewing
authors.affiliation: Centre for Family Research, University of Cambridge, Free School Lane, Cambridge CB2 3RQ, UK.
authors.forename: Nothando
authors.initials: N
authors.lastname: Ngwenya
authors.affiliation: Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
authors.forename: John
authors.initials: J
authors.lastname: Benson
authors.affiliation: Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gilligan
authors.affiliation: Formerly Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Bailey
authors.affiliation: School of Health Sciences, The University of Nottingham, Nottingham NG7 2UH, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Seymour
authors.affiliation: Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
authors.forename: Morag
authors.initials: M
authors.lastname: Farquhar
mesh_terms: D000368:Aged; D003142:Communication; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D033062:Friends / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012944:Social Support; D014342:Truth Disclosure
keywords: Cancer; Communication; Diagnosis; Intervention; Qualitative research