Sharing news of a lung cancer diagnosis with adult family members and friends: a qualitative study to inform a supportive intervention

• Existing research has focused on breaking bad news by clinicians.
• Little is known about how patients subsequently share bad news with others.
• Sharing bad news is a challenging and individualised process.
• There is a patient–clinician mismatch of perceptions of support with sharing bad news.
• An identified framework of six core elements of sharing bad news could inform an intervention.

ObjectiveExtensive research exists on breaking bad news by clinicians. This study examines perspectives of patients and those accompanying them at diagnosis-giving of subsequently sharing news of lung cancer with adult family/friends, and views of healthcare professionals, to inform development of a supportive intervention.MethodsQualitative interviews with 20 patients, 17 accompanying persons; focus groups and interviews with 27 healthcare professionals from four Thoracic Oncology Units. Intervention development workshops with 24 healthcare professionals and six service users with experience of sharing a cancer diagnosis. Framework thematic analysis.ResultsPatients and accompanying persons shared news of lung cancer whilst coming to terms with the diagnosis. They recalled general support from healthcare professionals but not support with sharing bad news. Six elements were identified providing a framework for a potential intervention: 1-people to be told, 2-information to be shared, 3-timing of sharing, 4-responsibility for sharing, 5-methods of telling others and 6-reactions of those told.ConclusionThis study identifies the challenge of sharing bad news and a potential framework to guide delivery of a supportive intervention tailored to individual needs of patients.Practice ImplicationsThe identified framework could extend the portfolio of guidance on communication in cancer and potentially in other life-limiting conditions.