Patients' attitudes to risk in lung cancer surgery: a qualitative study

Powell, Helen A.; Jones, Laura L.; Baldwin, David R.; Duffy, John P.; Hubbard, Richard B.; Tod, Angela M.; Solomon, Josie; Bains, Manpreet

Abstract

Objectives
Lung cancer surgery leads to long term survival for some patients but little is known about how patients decide whether to accept the associated surgical risks. The objective of this qualitative study was to explore patients’ attitudes to the risks associated with lung cancer surgery.

Methods
Fifteen patients with resectable lung cancer, recruited via multi-disciplinary team meetings at an English tertiary referral centre, participated in semi-structured interviews to explore their attitudes to the morbidity and mortality risks associated with lung cancer surgery. Transcripts were analysed using the framework method.

Results
Participants reported being ‘pleased’ to hear that they were suitable for surgery and felt that surgery was not a treatment to be turned down because they did not see any
alternatives. Participants had some knowledge of perioperative risks, including mortality estimates; however, many voiced a preference not to know these risks and to let the medical team decide their treatment plan. Some found it difficult to relate the potential risks and complications of surgery to their own situation and appeared willing to accept high perioperative mortality risks. Generally, participants were willing to accept quite severe long-term postoperative breathlessness; however, it was apparent that many actually found this possibility difficult to imagine.

Conclusion
Patients do not necessarily wish to know details of risks associated with lung cancer surgery and may wish to defer decisions about treatment to their medical team. Investment in the doctor-patient relationship, particularly for the surgeon, is therefore
important in the management of patients with lung cancer.

Citation

Powell, H. A., Jones, L. L., Baldwin, D. R., Duffy, J. P., Hubbard, R. B., Tod, A. M., …Bains, M. (2015). Patients' attitudes to risk in lung cancer surgery: a qualitative study. Lung Cancer, 90(2), https://doi.org/10.1016/j.lungcan.2015.08.014

• Journal Article Type: Article
• Acceptance Date: Aug 19, 2015
• Online Publication Date: Aug 24, 2015
• Publication Date: Nov 1, 2015
• Deposit Date: Mar 1, 2016
• Publicly Available Date: Mar 1, 2016
• Journal: Lung Cancer
• Print ISSN: 0169-5002
• Electronic ISSN: 0169-5002
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 90
• Issue: 2
• DOI: https://doi.org/10.1016/j.lungcan.2015.08.014
• Keywords: Lung neoplasm; Thoracic surgery; Risk; Mortality; Morbidity; Qualitative Research.
• Public URL: https://nottingham-repository.worktribe.com/output/981462
• Publisher URL: http://www.sciencedirect.com/science/article/pii/S0169500215300386