Date Available

4-24-2024

Year of Publication

2024

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Angela Grubbs

Committee Member

Dr. Elizabeth Tovar

Committee Member

Dr. Julie Ossege

Co-Director of Graduate Studies

Leah Yeager

Abstract

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used a quasi-experimental one group pre-test, post-test design. A pre-chart review determined participant eligibility. Baseline data were obtained through a pre-survey. After appointment, cancer survivors participated in an individual lung cancer screening educational intervention. Post intervention, change in knowledge, willingness to be screened, referral rates, and screening rates were measured. A retrospective chart review examined screening rates and chest CT results.

Results: A total of eight patients participated in this project. Overall, there was an increase in all mean values from pre-survey to post-survey. The increase was statistically significant for one item. The mean score for “I know something about lung cancer screening” significantly increased from 3.5 (SD=1.41) before intervention to 4.9 (SD=0.35) after intervention, p=.028. A retrospective chart review could not evaluate the effect of the educational intervention on lung cancer screening referrals and screening rates post intervention, as 100% of participants received a chest CT scan prior to the intervention per oncology surveillance guidelines. However, a retrospective chart review analyzed the results from these scans. The retrospective chart review found that four participants (50%) had no pulmonary nodules, two (25%) had stable pulmonary nodules, one (12.5%) had a new nodule, and one (12.5%) had nodules that had increased in size.

Conclusion: An educational intervention with a concurrent decision aid can be an effective way to improve lung cancer screening knowledge. Although most participants had heard of lung cancer screening and knew they were eligible prior to intervention, they were lacking knowledge about lung cancer screening. Education not only improves knowledge but positively impacts interest and willingness to be referred for screening. Analyzing chest CT scan results indicated the importance of lung cancer screening for asymptomatic, high-risk individuals.

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