• Christopher G Slatore, Nancy Press, David H Au, J Randall Curtis, Renda Soylemez Wiener, and Linda Ganzini.
• Health Services Research and Development, Portland Veterans Affairs Medical Center, Portland, OR, USA. christopher.slatore@va.gov
• Ann Am Thorac Soc. 2013 Aug 1;10(4):330-5.

RationaleEvery 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.ObjectivesThe purpose of this study was to explore the experiences of patients with incidentally diagnosed pulmonary nodules.MethodsWe 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 ResultsThe 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.ConclusionsVeterans 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.

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