Guided self-determination for patients with non-small cell lung cancer: Patients' experiences of a nurse-led person-centred intervention

PURPOSE: Guided self-determination is an empowering person-centred approach that has proven useful in empowering different patient groups but has not yet been tested in lung cancer patients. The purpose of the study was to examine how patients with stage III non-small cell lung cancer in concomitant chemoradiotherapy could benefit from a guided self-determination course.

METHODS: A prospective intervention study with both quantitative and qualitative data. Patients (n = 20) were offered four guided self-determination conversations with a nurse. Symptoms and quality of life were measured through questionnaires and semi-structured interviews elicited thirteen patients' experiences. Thematic analysis was conducted, and the Consolidated Criteria for Mixed Method Research was used for reporting.

RESULTS: No difference in quality of life were found but significant worsening of pain, dyspnea, diarrhoea and dysphagia. Six themes were generated describing that in a new, uncertain and lonely situation with a life-threatening disease, the patients appreciated a respectful relationship with a nurse, and conversations with the nurse became a lifeline. Some patients felt increasingly empowered through new insights, while others felt that it became too intimate.

CONCLUSION: When patients with a serious disease can draw on nurses' knowledge and experience, they are empowered to manage everyday life. Some patients need supportive and reflective conversations, while others benefit from concrete problem-solving objectives.