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Malene Missel

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    OA04 - Improving Access and Outcomes in Lung Cancer Management (ID 898)

    • Event: WCLC 2018
    • Type: Oral Abstract Session
    • Track: Nursing and Allied Professionals
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 10:30 - 12:00, Room 201 F
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      OA04.06 - Perceptions of Non-Participation in a Rehabilitation Intervention After Surgery for Non-Small Cell Lung Cancer (ID 12058)

      11:25 - 11:35  |  Author(s): Malene Missel

      • Abstract
      • Presentation
      • Slides


      Patients with non-small lung cancer (NSCLC) are difficult to engage in clinical trials. Few studies have examined in-depth why these patients refuse to participate. In a Danish randomized clinical trial; ’Postoperative rehabilitation in operable lung cancer patients (PROLUCA)’ only 32% of eligible participants consented to participate in the trial. The purpose of this qualitative study was therefore to explore perceptions, considerations and barriers of non-participation in PROLUCA.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This study was inspired by Reflective Life Research as developed by Dahlberg et al. as a descriptive and interpretive phenomenological research approach. Participants are patients who declined to participate in PROLUCA (non-participants). They were purposefully sampled and recruited from the group of patients who were found to be eligible for the exercise intervention but who declined to participate. Data were collected though telephone interviews. Openness, curiosity and sensitivity played an important role in carrying out the interviews. Analysis was performed according to Reflective Life Research.

      4c3880bb027f159e801041b1021e88e8 Result

      Fifteen non-participants consented to participate in qualitative interviews. Nine men and six women with a mean age of 68 years (range 48-84) were included. Mean time since surgery was 21 month (range 12-28). Five patients were working and ten were retired, eleven patients lived with a partner.

      The analysis revealed three essential themes referred to the patients’ experiences of being ‘Between healthy life and good life’, ‘Under the influence of society’ and their experiences of ‘Health and rehabilitation as a personal responsibility’. Perceptions of non-participation in rehabilitation after surgery for lung cancer are moderated between freedom and necessity. Patients experience ambivalence between a wish to participate in rehabilitation and not having the energy to participate. Patients refused to participate due to daily life priorities and lack of motivation which furthermore is related to social and interpersonal relationships. The patients exercise history is also essential in declining participation. Additionally the patients are under influence of norms and health perceptions from the society.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Patients’ perception of "the good life" was fundamental for accepting or declining participation in a rehabilitation intervention study. Consideration and barriers of non-participation was influenced by norms from the society, motivation, priorities, exercise history, social and interpersonal relations.

      This study has contributed with a sensitive awareness of why patients following lung cancer surgery might refuse participating in rehabilitation. This knowledge can be taken into consideration in the planning of future clinical trials with lung cancer patients.


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