title: Barriers to lung cancer care: health professionals' perspectives.
abstract: Globally, lung cancer is the most common cancer and the leading cause of cancer death. Problematically, there is a wide variation in the management and survival for people with lung cancer and there is limited understanding of the reasons for these variations. To date, the views of health professionals across relevant disciplines who deliver such care are largely absent. The present study describes Australian health professionals' views about barriers to lung cancer care to help build a research and action agenda for improving lung cancer outcomes.
  
  
  
  Qualitative semi-structured interviews were undertaken with a multidisciplinary group of 31 Australian health professionals working in lung cancer care for an average of 16 years (range 1-35 yrs.; SD = 10.2) seeing a mean of 116 patients annually.
  
  
  
  Three superordinate themes were identified: illness representations, cultural influences, and health system context. Illness representations included three themes: symptoms attributed as smoking-related but not cancer, health-related stigma, and therapeutic nihilism. Cultural influence themes included Indigenous health care preferences, language and communication, and sociodemographic factors. Health system context included lack of regional services and distance to treatment, poor care coordination, lack of effective screening methods, and health professional behaviours.
  
  
  
  Fractured and locally isolated approaches routinely confound responses to the social, cultural and health system complexities that surround a diagnosis of lung cancer and subsequent treatment. Improving outcomes for this disadvantaged patient group will require government, health agencies, and the community to take an aggressive, integrated approach balancing health policy, treatment priorities, and societal values.
authors.affiliation: Cancer Council Queensland, Brisbane, Australia.|Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Australia.|Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.|School of Social Science, University of Queensland, Brisbane, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Dunn
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Garvey
authors.affiliation: Cancer & Chronic Disease Research Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: P C
authors.initials: PC
authors.lastname: Valery
authors.affiliation: Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.|Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Ball
authors.affiliation: Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia.|Thoracic Research Centre, University of Queensland, Brisbane, QLD, Australia.
authors.forename: K M
authors.initials: KM
authors.lastname: Fong
authors.affiliation: Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.|South Western Sydney Clinical School, University of NSW, Sydney, Australia.|Western Sydney University, Sydney, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Vinod
authors.affiliation: Cancer Council New South Wales, Sydney, Australia.|School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.|Sydney Medical School - Public Health, University of Sydney, Sydney, Australia.
authors.forename: D L
authors.initials: DL
authors.lastname: O'Connell
authors.affiliation: Cancer Council Queensland, Brisbane, Australia. suzanne.chambers@griffith.edu.au.|Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Australia. suzanne.chambers@griffith.edu.au.|Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. suzanne.chambers@griffith.edu.au.|Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia. suzanne.chambers@griffith.edu.au.
authors.forename: S K
authors.initials: SK
authors.lastname: Chambers
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D003695:Delivery of Health Care; D005260:Female; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D036301:Qualitative Research; D057545:Social Stigma; D035862:Vulnerable Populations
keywords: Health professionals’ attitudes; Lung cancer; Nihilism; Stigma