背景:肺癌是英国第三大常见癌症,也是全球癌症死亡的主要原因。NHS英格兰最佳肺癌护理指南建议由专家团队进行管理和治疗,专家集中在一个地方,提供专业诊断和治疗设施。然而,复杂而快速发展的肺癌诊断和治疗途径,加上劳动力的限制,实现这一挑战。这个地方,行为科学的定性研究旨在探索与人相关的特征如何与人的位置相对于专科服务相互作用,以影响他们与最佳肺通路的参与,比较和对比农村的经验,沿海,和城市社区。本研究还旨在产生可翻译的证据,以告知基于证据的患者参与干预设计,以改善肺癌患者和非正式护理人员对肺癌护理途径的参与和体验。
方法:一项针对招募前<6个月被诊断患有肺癌的人的定性横断面访谈研究(接受手术,根治性放疗,或患有晚期疾病)及其非正式照顾者。参与者将有目的地从BartsHealthNHSTrust和联合林肯郡医院NHSTrusts招募,以确保城市和农村地区的多样化样本。半结构化访谈将探索影响个人能力的因素,机会,以及参与他们推荐的诊断和治疗途径的动机。框架方法,由COM-B模型通知,将用于主题分析促进者和患者参与的障碍。
结论:该研究符合当前的政策重点,以确保癌症患者,不管他们住在哪里,可以获得最优质的治疗和护理。产生的证据将用于确保发展肺癌服务以满足农村需求,沿海,和城市社区。这些发现将为干预措施的发展提供信息,以支持患者参与其推荐的肺癌途径。
背景:该研究于2023年4月8日获得了NHS研究伦理委员会(Ref:23/SC/0255)和NHS健康研究管理局(IRASID328531)的批准。该研究在开放科学框架(2023年10月16日;https://osf.io/njq48)上进行了前瞻性注册。
BACKGROUND: Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person\'s location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients\' and informal carers\' participation in and experience of the lung cancer care pathway.
METHODS: A qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals\' capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement.
CONCLUSIONS: The study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway.
BACKGROUND: The study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023; https://osf.io/njq48 ).