What the heck is a "nodule"? A qualitative study of Veterans with pulmonary nodules

Christopher G. Slatore, Nancy Press, David H. Au, J. Randall Curtis, Renda Soylemez Wiener, Linda Ganzini

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Rationale: Every year, hundreds of thousands of patients are diagnosed with incidentally detected pulmonary nodules, and if lung cancer screening is widely implemented, thousands more will be identified. The psychosocial outcomes associated with incidental nodule detection in general practice settings are virtually unknown. Objectives: Thepurpose of this studywas to explore the experiences of patients with incidentally diagnosed pulmonary nodules. Methods: We conducted qualitative interviews of 19 veterans with incidentally detected pulmonary nodules. We used qualitative description for the analysis, focusing on patients' information exchange and other communication behaviors with their clinicians. Measurements and Main Results: The patients were cared for by primary care clinicians and had small nodules that were unlikely to be malignant. Patients did not understand the term "nodule" although they knew it was related to cancer. They also did not understand the follow-up plan and most were unable to obtain better information from their clinician or other sources. Most patients experienced nodule-related distress that was usually mild, although sometimes severe. This distress was sometimes mitigated by patients' confidence in their clinician. Most patients wanted more and better information about their nodule. Conclusions: Veterans from one hospital have little understanding of what nodules are, the likelihood of malignancy, and the followup plan. Their reaction to this knowledge deficit is variable and is likely related to preferred communication behaviors with their clinician. Evaluating communication in other settings is important to confirm these findings and to refine mechanisms to improve patientcentered care for those with incidentally detected pulmonary nodules.

Original languageEnglish (US)
Pages (from-to)330-335
Number of pages6
JournalAnnals of the American Thoracic Society
Volume10
Issue number4
DOIs
StatePublished - Aug 2013

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Veterans
Lung
Communication
Veterans Hospitals
Early Detection of Cancer
General Practice
Lung Neoplasms
Neoplasms
Primary Health Care
Interviews

Keywords

  • Communication
  • Lung cancer
  • Patient-centered outcomes
  • Pulmonary nodule

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

What the heck is a "nodule"? A qualitative study of Veterans with pulmonary nodules. / Slatore, Christopher G.; Press, Nancy; Au, David H.; Curtis, J. Randall; Wiener, Renda Soylemez; Ganzini, Linda.

In: Annals of the American Thoracic Society, Vol. 10, No. 4, 08.2013, p. 330-335.

Research output: Contribution to journalArticle

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abstract = "Rationale: Every year, hundreds of thousands of patients are diagnosed with incidentally detected pulmonary nodules, and if lung cancer screening is widely implemented, thousands more will be identified. The psychosocial outcomes associated with incidental nodule detection in general practice settings are virtually unknown. Objectives: Thepurpose of this studywas to explore the experiences of patients with incidentally diagnosed pulmonary nodules. Methods: We conducted qualitative interviews of 19 veterans with incidentally detected pulmonary nodules. We used qualitative description for the analysis, focusing on patients' information exchange and other communication behaviors with their clinicians. Measurements and Main Results: The patients were cared for by primary care clinicians and had small nodules that were unlikely to be malignant. Patients did not understand the term {"}nodule{"} although they knew it was related to cancer. They also did not understand the follow-up plan and most were unable to obtain better information from their clinician or other sources. Most patients experienced nodule-related distress that was usually mild, although sometimes severe. This distress was sometimes mitigated by patients' confidence in their clinician. Most patients wanted more and better information about their nodule. Conclusions: Veterans from one hospital have little understanding of what nodules are, the likelihood of malignancy, and the followup plan. Their reaction to this knowledge deficit is variable and is likely related to preferred communication behaviors with their clinician. Evaluating communication in other settings is important to confirm these findings and to refine mechanisms to improve patientcentered care for those with incidentally detected pulmonary nodules.",
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