Document Type
Journal Article
Publisher
Oxford University Press
School
School of Nursing and Midwifery
RAS ID
25399
Funders
National Health and Medical Research Council (NHMRC grant ID 1064121)
Cancer Australia Primary Care Collaborative Cancer Clinical Trials Group (PC4)
Grant Number
NHMRC Number : 1064121
Abstract
Background
Lung cancer has one of the lowest survival outcomes of any cancer because over two-thirds of patients are diagnosed when curative treatment is no longer possible, partly due to later presentation with symptoms to a healthcare provider.
Objective
To explore the theoretical underpinning of the Scottish CHEST intervention in participants randomized to the intervention group within the CHEST Australia trial.
Methods
A purposive maximum variation sample of participants who received the intervention in the CHEST trial in Perth, Western Australia (N = 13) and Melbourne, Victoria, (N = 7) were interviewed. Patients were asked about their experience of the CHEST consultation, their recall of the main messages, their symptom appraisal and issues relating to help seeking when they develop symptoms. Thematic analysis was conducted to draw common themes between the participants.
Results
We identified themes consistent with the theoretical basis of the CHEST intervention. Barriers to consultation identified in the CHEST Australia trial participants were smoker stigmatization, guilt, fatalism and symptom normalization. We identified a general perceived mistrust of GPs based on previous negative experiences of visiting their GP in relation to their smoking. The intervention tackled barriers around lecturing and feelings of guilt and stigma related to smoking. We identified expected effects on salience and personal relevance of symptoms. Participants reported a clearer understanding of what to look out for and when to take action after the CHEST intervention.
Conclusions
These findings suggest that the CHEST Australia intervention is achieving the desired objectives at the qualitative level through the proposed theoretical mechanisms.
DOI
10.1093/fampra/cmx057
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Murray, S. R., Kutzer, Y., Habgood, E., Murchie, P., Walter, F. M., Mazza, D., ... & Emery, J. D. (2017). Reducing barriers to consulting a General Practitioner in patients at increased risk of lung cancer: A qualitative evaluation of the CHEST Australia intervention. Family practice, 34 (6), 740-746.
https://doi.org/10.1093/fampra/cmx057