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Health and supportive care needs of surgical lung cancer patients, and the prognostic significance of smoking

Farley, Amanda Claire (2014)
Ph.D. thesis, University of Birmingham.

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Abstract

Aims: This thesis investigated the health and supportive care needs of surgical lung cancer patients to address gaps in the evidence base and inform future service developments. Additionally, the prognostic significance of smoking behaviour was investigated. Methods: Semi-structured interviews were conducted with 29 surgical (VATS and thoracotomy) lung cancer patients to explore health, functioning, smoking, satisfaction with recovery and preferences for a tailored rehabilitation programme. Interviews were analysed using framework approach. Systematic literature searches were conducted to review evidence of the association between smoking history or continued smoking after diagnosis and prognosis. Survival estimates were combined where possible using a random effect inverse variance model. Results: Most participants experienced difficulty during recovery. Breathlessness and pain emerged as dominant health challenges. Participants were open to being offered smoking cessation support. From 78 and 10 studies, preliminary evidence was found that both smoking history and continued smoking are associated with prognosis, respectively. Analyses indicated that smoking-associated increased risk may be mediated through cancer-related pathways. Conclusions: Many surgical lung cancer patients’ supportive care needs are not being met. Well-developed treatments and services for management of breathlessness, pain and smoking cessation may improve quality of life and health outcomes after lung cancer surgery, and require further testing.

Type of Work:Ph.D. thesis.
Supervisor(s):Aveyard, Paul and Dowswell, George
Department:School of Health and Population Sciences
Subjects:RA0421 Public health. Hygiene. Preventive Medicine
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
RZ Other systems of medicine
Institution:University of Birmingham
ID Code:4979
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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