A Decision Aid to Improve Abstinence and HRQL for Families Facing Lung Cancer
July 2011-2013, Principal Investigator: Karen Kane McDonnell, PhD, RN, OCN
Funded by the American Cancer Society (ACS) in 2015, this 6-month, prospective, one-group repeated measures, mixed-method design study—grounded in social cognitive theory and the conflict theory of decision making—evaluated the feasibility of a multidisciplinary interactive decision aid, Tobacco Free Family.
Participants were patients anticipating thoracic surgery and their family members (dyads), all of whom were current smokers, Caucasian, and residents of rural areas. The study had a 44% recruitment and 100% retention rate. At 6 months post-op, patients reported difficulty managing respiratory symptoms and fatigue as they returned to work and daily activities. Family members were willing to try to stop smoking but wanted greater control over timing and needed more intensive help with other health issues (e.g., stress management, sedentary behavior).
This study supported existing evidence that survivors of lung cancer have long-term difficulty managing symptoms (dyspnea, fatigue and stress) and that focusing on a single behavior is not an effective or sufficient solution. Patients were very interested in participating in a formal program for behavior change. However, even in this study with 100% retention, traveling to participate in a study was difficult. Patients specified a preference for a home-based or mobile intervention format. A majority of participants returned to work after completing lung cancer treatment. Three manuscripts were published and several abstracts were submitted for presentation based on this work, including the following:
- McDonnell, K. K., Bullock, L. F., Hollen, P. J., Heath, J., & Kozower, B. D. (2014). Evidence and emerging issues on the impact of smoking on HRQL in individuals with lung cancer and their families. Clinical Journal of Oncology Nursing, 18, 171–81.
- McDonnell, K. K., Bullock, L. F., Hollen, P. J., Heath, J., Rovnyak, V., & Kozower, B. D. (2014). A decision aid to improve smoking abstinence for families facing cancer: Tobacco Free Family; Helping family dyads confronting cancer to stop smoking. Oncology Nursing Forum, 41(6), 1–10.
- McDonnell, K. K., Hollen, P. J., Heath, J., & Andrews, J. O. (2016 February). Recruiting family dyads facing thoracic cancer surgery: Challenges and lessons learned from a smoking cessation intervention. European Journal of Oncology Nursing, 199–206. doi:10.1016/j.ejon.2015.08.006
- McDonnell, K. K., Bullock, L. F., Hollen, P. J., Heath, J., & Kozower, B. D. (2014 November). A decision aid to improve smoking abstinence for families facing cancer: A Tobacco Free Family; Helping dyads confronting cancer to stop smoking [Abstract]. Connections: Advancing Care through Science. Dallas, TX: Oncology Nursing Society.
- McDonnell, K. K. (2013 October). Women struggle to be smoke-free: Supporting partners with cancer. Poster presented at the Carolina Women’s Health Research Forum, University of South Carolina School of Medicine, Columbia, SC.