title: Lung cancer treatment rates and the role of the lung cancer nurse specialist: a qualitative study.
abstract: OBJECTIVE
  This qualitative study examines how the Lung Cancer Nurse Specialist (LCNS) role operates and why they may be able to increase access to treatment.
  
  
  METHODS
  4 Hospital NHS Foundation Trusts in England.
  
  
  METHODS
  A multiple case study design using semistructured interviews, observation and Framework Analysis techniques.
  
  
  METHODS
  Four LCNSs, comprised the 'cases'. Twenty four clinicians who worked with the LCNS participated in individual interviews. Six LCNSs took part in a group interview and 60 lung cancer multidisciplinary team (MDT) members and coordinators were observed in the MDT meeting.
  
  
  RESULTS
  The LCNS is crucial within the MDT and can act as a catalyst to patient access to treatment. The study identified the clinical activity (assessment, managing symptoms, psychological support and information provision) and role characteristics that can facilitate treatment access. These characteristics are the LCNS's presence across the patient pathway, acting as the 'hub' of the MDT, maintaining a holistic patient focus and working to an advanced level of practice. The findings indicate how factors may have a cumulative impact on treatment access.
  
  
  CONCLUSIONS
  If UK patient with lung cancer survival rates are to improve in line with comparable countries, we need to employ every advantage. This study demonstrates how the LCNS role may open doors to positive patient outcomes, including treatment. Further research is required to explore patients' experiences, decision-making and attitudes to treatment.
authors.affiliation: School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
authors.forename: Angela Mary
authors.identifier: http://orcid.org/0000-0001-6336-3747
authors.initials: AM
authors.lastname: Tod
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, England.
authors.forename: Judy
authors.initials: J
authors.lastname: Redman
authors.affiliation: Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, England.
authors.forename: Ann
authors.initials: A
authors.lastname: McDonnell
authors.affiliation: Edinburgh Cancer Centre, Western General Hospital, Edinburgh, Scotland.
authors.forename: Diana
authors.initials: D
authors.lastname: Borthwick
authors.affiliation: St James`s Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, England.
authors.forename: John
authors.initials: J
authors.lastname: White
mesh_terms: D003661:Decision Support Techniques; D004739:England / Q000453:epidemiology; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000451:nursing* / Q000628:therapy; D009720:Nurse Clinicians / Q000458:organization & administration; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010348:Patient Care Team / Q000458:organization & administration*; D011361:Professional Competence / Q000592:standards*; D036301:Qualitative Research; D016019:Survival Analysis
keywords: QUALITATIVE RESEARCH