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: The purpose of this study was 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 follow-up 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 patient-centered care for those with incidentally detected pulmonary nodules.
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: The purpose of this study was 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 follow-up 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 patient-centered care for those with incidentally detected pulmonary nodules.
Authors: Syed H Tariq; Nina Tumosa; John T Chibnall; Mitchell H Perry; John E Morley Journal: Am J Geriatr Psychiatry Date: 2006-11 Impact factor: 4.105
Authors: Christopher G Slatore; Laura Cecere Feemster; David H Au; Ruth A Engelberg; J Randall Curtis; Jane Uman; Lynn F Reinke Journal: J Health Commun Date: 2014-02-21
Authors: William E Holden; David M Lewinsohn; Molly L Osborne; Chris Griffin; Ann Spencer; Carol Duncan; Mark E Deffebach Journal: Chest Date: 2004-05 Impact factor: 9.410
Authors: Karien A M van den Bergh; Marie-Louise Essink-Bot; Eveline M Bunge; Ernst Th Scholten; Mathias Prokop; Carola A van Iersel; Rob J van Klaveren; Harry J de Koning Journal: Cancer Date: 2008-07-15 Impact factor: 6.860
Authors: Christopher G Slatore; Nanda Horeweg; James R Jett; David E Midthun; Charles A Powell; Renda Soylemez Wiener; Juan P Wisnivesky; Michael K Gould Journal: Am J Respir Crit Care Med Date: 2015-08-15 Impact factor: 21.405
Authors: Marc R Freiman; Jack A Clark; Christopher G Slatore; Michael K Gould; Steven Woloshin; Lisa M Schwartz; Renda Soylemez Wiener Journal: J Thorac Oncol Date: 2016-03-07 Impact factor: 15.609
Authors: Shannon M Nugent; Sara E Golden; Charles R Thomas; Mark E Deffebach; Mithran S Sukumar; Paul H Schipper; Brandon H Tieu; Drew Moghanaki; Juan Wisnivesky; Christopher Slatore Journal: Support Care Cancer Date: 2017-12-05 Impact factor: 3.603
Authors: Jonathan M Iaccarino; James Simmons; Michael K Gould; Christopher G Slatore; Steven Woloshin; Lisa M Schwartz; Renda Soylemez Wiener Journal: Ann Am Thorac Soc Date: 2017-06
Authors: Renda Soylemez Wiener; Jack A Clark; Elisa Koppelman; Rendelle Bolton; Gemmae M Fix; Christopher G Slatore; Hasmeena Kathuria Journal: Chest Date: 2020-05-07 Impact factor: 9.410
Authors: Anil Vachani; Nichole T Tanner; Jyoti Aggarwal; Charles Mathews; Paul Kearney; Kenneth C Fang; Gerard Silvestri; Gregory B Diette Journal: Ann Am Thorac Soc Date: 2014-12
Authors: Renda Soylemez Wiener; Michael K Gould; Christopher G Slatore; Benjamin G Fincke; Lisa M Schwartz; Steven Woloshin Journal: JAMA Intern Med Date: 2014-06 Impact factor: 21.873