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Lung cancer
Communication of a mesothelioma diagnosis: developing recommendations to improve the patient experience
  1. Bethany Hope Taylor1,
  2. Clare Warnock2 and
  3. Angela Tod1
  1. 1School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
  2. 2Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Dr Bethany Hope Taylor; btaylor3{at}sheffield.ac.uk

Abstract

Background Malignant pleural mesothelioma (MPM) is an aggressive cancer linked to asbestos exposure and inhalation. As with other cancers, receiving a diagnosis of MPM is challenging and distressing. Particular challenges are associated with communicating a diagnosis of MPM, including explaining the disease and its prognosis, treatment options and legal and financial implications. Receiving A Diagnosis Of Mesothelioma (RADIO Meso) aimed to understand the experience of communicating a diagnosis of MPM from the perspective of patients, family carers and health professionals.

Methods This qualitative study comprised 31 individual interviews with patients, family carers and health professionals. This was followed by two group interviews (n=42) and an electronic consultation exercise (n=39).

Results This study provides unique insight into the mesothelioma diagnostic experience of patients, family carers and health professionals. Key findings include the importance of regarding diagnosis as a process, and provision of continuity and consistency. The clinical nurse specialist and effective multidisciplinary team working provided vital contributions to successful mesothelioma diagnostic communication. Facilitators to diagnostic communication included honesty and timeliness in communication, partnership working and maintaining a patient-centred approach. Challenges to enhancing mesothelioma diagnosis communication included accessing ongoing training, ensuring a suitable clinical environment and being able to allocate appropriate time.

Conclusion The RADIO Meso study highlights factors that influence the communication of a diagnosis of MPM from the perspectives of individual patients and family carers. These findings provide the basis for a set of recommendations that can be used by health professionals to improve the MPM diagnostic experience.

  • mesothelioma
  • patient experience
  • diagnosis
  • communication
  • breaking bad news

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2019-000413

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    Footnotes

    • Contributors AT and CW had the original idea for the study. All authors contributed to the study design. BT and AT conducted the interviews. All authors participated in the analysis which was led by BT. All authors contributed and commented critically to the paper.

    • Funding Mesothelioma UK, (Meso1).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Research Ethics Committee approval was obtained from the University of Sheffield.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Our primary data is available upon request.