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Qualitative cross-country comparison of whether, when and how people diagnosed with lung cancer talk about cigarette smoking in narrative interviews

Hajdarevic, Senada ; Rasmussen, Birgit H. LU ; Overgaard Hasle, Trine L. and Ziebland, Sue (2018) In BMJ Open 8(11). p.023934-023934
Abstract

OBJECTIVES: To compare and examine whether, when and how patients with lung cancer in three countries, with different survival rates, talk about cigarette smoking and its relationship with help-seeking. DESIGN: A qualitative cross-country comparison with analysis of narrative interviews. SETTING: Participants in Sweden, Denmark and England were interviewed during 2015-2016. Interviews, using a narrative approach, were conducted in participants' home by trained and experienced qualitative researchers. PARTICIPANTS: Seventy-two men and women diagnosed with lung cancer were interviewed within 6 months of their diagnosis. RESULTS: The English participants, regardless of their own smoking status, typically raised the topic of smoking early... (More)

OBJECTIVES: To compare and examine whether, when and how patients with lung cancer in three countries, with different survival rates, talk about cigarette smoking and its relationship with help-seeking. DESIGN: A qualitative cross-country comparison with analysis of narrative interviews. SETTING: Participants in Sweden, Denmark and England were interviewed during 2015-2016. Interviews, using a narrative approach, were conducted in participants' home by trained and experienced qualitative researchers. PARTICIPANTS: Seventy-two men and women diagnosed with lung cancer were interviewed within 6 months of their diagnosis. RESULTS: The English participants, regardless of their own smoking status, typically raised the topic of smoking early in their interviews. Smoking was mentioned in relation to symptom appraisal and interactions with others, including health professionals. Participants in all three countries interpreted their symptoms in relation to their smoking status, but in Sweden (unlike England) there was no suggestion that this deterred them from seeking care. English participants, but not Swedish or Danish, recounted reluctance to consult healthcare professionals with their symptoms while they were still smoking, some gave up shortly before consulting. Some English patients described defensive strategies to challenge stigma or pre-empt other people's assumptions about their culpability for the disease. A quarter of the Danish and 40% of the Swedish participants did not raise the topic of smoking at any point in their interview. CONCLUSION: The causal relationship between smoking and lung cancer is well known in all three countries, yet this comparative analysis suggests that the links between a sense of responsibility, stigma and reluctance to consult are not inevitable. These findings help illuminate why English patients with lung cancer tend to be diagnosed at a later stage than their Swedish counterparts.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
lung cancer, organisation of health services, patients' experiences, qualitative comparative study, smoking
in
BMJ Open
volume
8
issue
11
pages
023934 - 023934
publisher
BMJ Publishing Group
external identifiers
  • scopus:85056351393
  • pmid:30420351
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-023934
language
English
LU publication?
yes
id
03fb4821-cac3-4e36-b28b-96481f5f0309
date added to LUP
2018-11-21 14:41:30
date last changed
2021-10-06 03:45:56
@article{03fb4821-cac3-4e36-b28b-96481f5f0309,
  abstract     = {<p>OBJECTIVES: To compare and examine whether, when and how patients with lung cancer in three countries, with different survival rates, talk about cigarette smoking and its relationship with help-seeking. DESIGN: A qualitative cross-country comparison with analysis of narrative interviews. SETTING: Participants in Sweden, Denmark and England were interviewed during 2015-2016. Interviews, using a narrative approach, were conducted in participants' home by trained and experienced qualitative researchers. PARTICIPANTS: Seventy-two men and women diagnosed with lung cancer were interviewed within 6 months of their diagnosis. RESULTS: The English participants, regardless of their own smoking status, typically raised the topic of smoking early in their interviews. Smoking was mentioned in relation to symptom appraisal and interactions with others, including health professionals. Participants in all three countries interpreted their symptoms in relation to their smoking status, but in Sweden (unlike England) there was no suggestion that this deterred them from seeking care. English participants, but not Swedish or Danish, recounted reluctance to consult healthcare professionals with their symptoms while they were still smoking, some gave up shortly before consulting. Some English patients described defensive strategies to challenge stigma or pre-empt other people's assumptions about their culpability for the disease. A quarter of the Danish and 40% of the Swedish participants did not raise the topic of smoking at any point in their interview. CONCLUSION: The causal relationship between smoking and lung cancer is well known in all three countries, yet this comparative analysis suggests that the links between a sense of responsibility, stigma and reluctance to consult are not inevitable. These findings help illuminate why English patients with lung cancer tend to be diagnosed at a later stage than their Swedish counterparts.</p>},
  author       = {Hajdarevic, Senada and Rasmussen, Birgit H. and Overgaard Hasle, Trine L. and Ziebland, Sue},
  issn         = {2044-6055},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {023934--023934},
  publisher    = {BMJ Publishing Group},
  series       = {BMJ Open},
  title        = {Qualitative cross-country comparison of whether, when and how people diagnosed with lung cancer talk about cigarette smoking in narrative interviews},
  url          = {http://dx.doi.org/10.1136/bmjopen-2018-023934},
  doi          = {10.1136/bmjopen-2018-023934},
  volume       = {8},
  year         = {2018},
}