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Title: Exploring the decision-making experiences of people with advanced lung cancer and their palliative care professionals
Author: Roulston , Audrey Lynn
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2013
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This study aims to identify and explore the experiences of people living with advanced lung cancer and their palliative care professionals across one Health and Social Care Trust in Northern Ireland. The objective was to obtain a greater understanding of decision-making in palliative and end of life care by professionals and patients. The study sample consisted of two purposively selected groups: professionals (n;10) working in one community specialist palliative care team; and patients (n;12) diagnosed with primary lung cancer, being cared for by the community palliative care team. Qualitative data were collected during two focus group meetings with professionals (each lasting 60 minutes); and two individual interviews with each of the 12 patients (mean duration 48 minutes). Interview schedules were informed by the Llewellyn Thomas (1995) framework. They explored practical and ethical challenges regarding decision-making; socio demographic and socio political factors influencing decision making; and how to promote high quality palliative and end of life care. Patient data were analysed using Interpretative Phenomenological Analysis (IPA) (Smith et aI., 2009). Analysis of patient interviews revealed three cross-cutting themes: the preciousness of time, the importance of communication and the maintenance of hope. Emergent themes from the patient findings are presented in the framework of narrative chronology, i.e. beginnings, middles and endings/futures, so as to mirror the patient's journey through illness. Frank's (1995) narrative typology of restitution, chaos .and quest were used to explore how patients told their stories. The focus group data were also analysed using IPA (Smith et aI., 2009). Super-ordinate themes identified were: time, communication and decision-making. Findings from the study provide insights into the patients' experiences of lung cancer, what influenced decision-making throughout the illness trajectory. It is hoped that messages from this research may help to inform end of life care policy initiatives and professional practice within palliative care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available