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

Lung Cancer. 2015 Nov;90(2):358-63. doi: 10.1016/j.lungcan.2015.08.014. Epub 2015 Aug 24. Patients' attitudes to risk in lung cancer surgery: A qualitative study. Powell HA1, Jones LL2, Baldwin DR3, Duffy JP4, Hubbard RB5, Tod AM6, Tata LJ5, Solomon J7, Bains M5. Author information 1 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. Electronic address: helen.powell5@nhs.net. 2 Public Health, Epidemiology & Biostatistics, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. 3 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK. 4 Department of Thoracic Surgery, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK. 5 University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. 6 School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK. 7 Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester LE1 9BH, UK.

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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS: Lung neoplasm; Morbidity; Mortality; Qualitative Research; Risk; Thoracic surgery

PMID: 26323214 DOI: 10.1016/j.lungcan.2015.08.014