scholarly journals Patient perspectives and experience on the diagnostic pathway of lung cancer: A qualitative study

2020 ◽  
Vol 8 ◽  
pp. 205031212091899
Author(s):  
Helle Marie Christensen ◽  
Lotte Huniche
Keyword(s):  
Lung Cancer ◽  
Qualitative Study ◽  
Health Professionals ◽  
Fast Track ◽  
Management Strategies ◽  
Hospital Setting ◽  
Diagnostic Process ◽  
Diagnostic Pathway ◽  
Cancer Diagnostic

Objectives: Lung cancer is one of the most common types of cancer, with high mortality rate and a significant burden of symptoms. It is therefore important to assess patients’ perceived quality of life during the diagnostic process and treatment. Knowledge of and attention to patients’ perspectives, experiences, and expectations in relation to lung cancer diagnostic pathways is limited. The aim of the study is to contribute with patients’ and relatives’ experiences with and their assessment of the quality of a hospital-based lung cancer diagnostic pathway. Methods: A qualitative study was conducted, comprising participant observation with 20 patients and semi-structured interviews with further 19 patients referred to the Lung Cancer Package, which initiates a fast track diagnostic pathway in a hospital setting. Data were obtained over a period of 9 months and analysed in collaboration with an interdisciplinary team of health professionals. The purpose was to further develop existing management strategies of the fast track diagnostic pathway based on patient’s perspectives. Results: Patients associated the fast track diagnostic pathway with high levels of anxiety due to the immediate risk of a lung cancer diagnosis. Although patients experienced the fast track programme as very challenging, they still wanted to move through the diagnostic pathway as quickly as possible. The patients expressed a need for support from relatives and repeatedly required information in multiple formats from health professionals throughout the diagnostic pathway. Conclusions: The study provided insight into the need for developing the fast track diagnostic pathway with a focus on patient anxiety, network involvement, and information strategies. The results qualified clinical practice with an increased focus on managing patients’ anxiety, raised awareness to involve relatives in the diagnostic process, and relaying information in dialogue with patients and their relatives, including management strategies to support patients through diagnostic investigations in the fast track programme.

Diagnosis and First-Line Treatment of Patients with Lung Cancer in Italian General Hospitals

1989 ◽  
Vol 75 (2) ◽  
pp. 163-167 ◽  
Author(s):  
◽  
Alexan Alexanian ◽  
Giovanni Apolone ◽  
Roldano Fossati Roberto Grilli ◽  
Paola Mosconi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell ◽  
Disease Stage ◽  
Diagnostic Process ◽  
Line Treatment ◽  
First Line ◽  
General Hospitals ◽  
Diagnostic Time ◽  
First Line Treatment

The quality of diagnostic and therapeutic care was examined in a series of 380 consecutive newly diagnosed cases of primary lung cancer seen in 20 Italian general hospitals between January and June 1987. At diagnosis most patients (78%) had one or more symptoms related to the tumor, and in an additional 9 % symptoms were related to the presence of distant metastases. The median diagnostic time lag between first symptoms and final diagnosis was 50 days with a significantly longer delay in patients first seen by their general practitioner compared with those who sought first care in hospital outpatient departments. The diagnostic process was satisfactorily carried out in fewer than two-thirds of the patients leading to complete ascertainment of disease stage and histology in 58% cases with significantly better performance in more specialized institutions. Analysis of the first-line treatment profile indicated a rather aggressive therapeutic attitude In the case of patients with non-small cell lung cancer – 28% of them had chemotherapy despite the lack of any proof of efficacy in controlled clinical trials – and a failure to identify among the patients with small cell disease those amenable to more aggressive treatment. The lack of progress in the treatment of lung cancer over the last decades seems to have resulted in widely varying practice patterns where a mixture of aggressive and laissez-faire attitudes does not take into account that in the absence of effective therapies a more conservative attitude would at least have some advantage in terms of quality of remaining life for many patients.

Faster and better: Improving the diagnostic phase of lung cancer at a system level.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 115-115
Author(s):  
Melissa Kaan ◽  
Claire Holloway ◽  
Julie Gilbert ◽  
Vicky Simanovski ◽  
Garth Matheson
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Patient Experience ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Diagnostic Process ◽  
Care Providers ◽  
The Past ◽  
Rule Out

115 Background: For many patients going through diagnostic testing for cancer, the time from suspicion to diagnosis or rule-out, can be a confusing and anxious time. In 2007, Cancer Care Ontario began investing in the implementation of diagnostic assessment programs (DAPs) across Ontario, Canada to improve the quality of care during the diagnostic phase of lung cancer. DAPs consist of multidisciplinary healthcare teams that manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis. The objectives of the DAPs are to: 1) decrease time from suspicion to diagnosis or resolution; 2) optimize the patient’s experience during the diagnostic process; 3) optimize satisfaction and experience among primary care providers and specialists; and 4) provide a sustainable solution by offering good value for money. Today over 35,000 patients have been diagnosed in one of the 18 lung DAPs that exist across the province. Methods: The implementation of DAPs featured the introduction of a patient navigator to act as the primary point of contact for patients, improve the patient experience and ensure their patients were progressing through any required diagnostic imaging and consultations in a timely manner. Cancer Care Ontario also engaged with primary care providers to refer patients with findings suspicious for lung cancer to DAPs as early as possible to ensure they benefited from organized assessment. Cancer Care Ontario has collected patient level data to measure wait times and implemented a patient survey to assess patient experience. Results: In the past five years, the median wait time from referral to a lung DAP to diagnosis or rule out has decreased by 19% to 24 days and the 90th %tile has decreased by 28% to 51 days. The large majority of patients have had a positive experience with their DAPs, with 95% of patients scoring their experience in the diagnostic process as “good” or “excellent”. Conclusions: The implementation of DAPs across the province is seen as a valuable component of quality of care by improving the diagnostic phase of cancer. The sustainability of the DAP model is demonstrated by the continued improvements in access and maintained patient experience in spite of growing volumes (91% increase in the past five years).

Concept Maps and Meaningful Learning

2010 ◽  
pp. 430-448
Author(s):  
Patricia Lupion Torres ◽  
Luiza Tatiana Forte ◽  
Josiane Maria Bortolozzi
Keyword(s):  
Health Professionals ◽  
Concept Maps ◽  
Hospital Setting ◽  
Meaningful Learning ◽  
Learning Objectives ◽  
Learning Object ◽  
Hospital Treatment ◽  
Health Educators ◽  
Teachers And Students

The search for meaningful learning promotes a rethinking of the approach adopted by teachers and students to take into account innovative methodologies based on previous experience of learning objectives. This article therefore describes the fundamentals of collaborative learning and the use of concept maps with different individuals in a hospital setting to promote learning about the complexity of their particular situation and in turn achieve higher levels of quality of life for school children receiving hospital treatment. The study also aimed to involve health professionals and health educators in this process and thus gather information to develop a Learning Object.

The role of a dedicated chest x-ray reporting tool in the lung cancer diagnostic pathway

2020 ◽  
Author(s):  
Helen Mcdill ◽  
Jon Noble ◽  
Eleanor Barton ◽  
Clemency Clarke ◽  
Martin Plummeridge ◽  
...  
Keyword(s):  
Lung Cancer ◽  
X Ray ◽  
Diagnostic Pathway ◽  
Cancer Diagnostic ◽  
Chest X Ray ◽  
Reporting Tool

61 Streamlining of the lung cancer diagnostic pathway in a district hospital: the result of good teamwork

Lung Cancer ◽  
2014 ◽  
Vol 83 ◽  
pp. S23
Author(s):  
C. Diver ◽  
P. Bhatia ◽  
J. Smart ◽  
N. Mason ◽  
A. Lama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
District Hospital ◽  
Diagnostic Pathway ◽  
Cancer Diagnostic

scholarly journals Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Heidi Bergenholtz ◽  
Malene Missel ◽  
Helle Timm
Keyword(s):  
Qualitative Study ◽  
End Of Life ◽  
Death And Dying ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Surgical Ward ◽  
Life Threatening ◽  
Depth Interviews ◽  
Acute Hospital Setting

Abstract Background End-of-life (EOL) conversations are highly important for patients living with life-threatening diseases and for their relatives. Talking about the EOL is associated with reduced costs and better quality of care in the final weeks of life. However, there is therefore a need for further clarification of the actual wishes of patients and their relatives concerning EOL conversations in an acute hospital setting. Aim The purpose of this study was to explore the wishes of patients and their relatives with regard to talking about the EOL in an acute hospital setting when living with a life-threatening disease. Methods This study is a qualitative study using semi-structured in-depth interviews. A total of 17 respondents (11 patients and six spouses) participated. The patients were identified by the medical staff in a medical and surgical ward using SPICT™. The interview questions were focused on the respondents’ thoughts on and wishes about their future lives, as well as on their wishes regarding talking about the EOL in a hospital setting. Results This study revealed that the wish to talk about the EOL differed widely between respondents. Impairment to the patients’ everyday lives received the main focus, whereas talking about EOL was secondary. Conversations on EOL were an individual matter and ranged from not wanting to think about the EOL, to being ready to plan the funeral and expecting the healthcare professionals to be very open about the EOL. The conversations thus varied between superficial communication and crossing boundaries. Conclusion The wish to talk about the EOL in an acute hospital setting is an individual matter and great diversity exists. This individualistic stance requires the development of conversational tools that can assist both the patients and the relatives who wish to have an EOL conversation and those who do not. At the same time, staff should be trained in initiating and facilitating EOL discussions.

48: Evaluating the use of PET-CT scan requests in the lung cancer diagnostic pathway – are we overusing this valuable resource?

Lung Cancer ◽  
2017 ◽  
Vol 103 ◽  
pp. S22
Author(s):  
E. Crawford ◽  
Z. Mustafa ◽  
S. Khan ◽  
I. Hussain ◽  
N. Maddekar ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Ct Scan ◽  
Valuable Resource ◽  
Diagnostic Pathway ◽  
Cancer Diagnostic ◽  
Pet Ct ◽  
Pet Ct Scan
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