Clinical issues
| Theme 1: clinical | ||
|---|---|---|
| Subtheme | Descriptor | Quotes |
| Knowledge about the patient and carer* | Identify a broad range of unknown patient and carer issues | ‘… have I asked in this area of physical problems, have I asked in the area of psychological symptoms, have I looked to see if they've got any spiritual assessments …’. (Expert group, P2) |
| Reminder to assess ‘non-medical’ issues | ‘… but when you go through the list you realise that there's someone with massive information needs and huge potential legal issues that no, nobody registered’. (Focus group, P4) | |
| Facilitate action and involvement of other professionals | ‘If people open up there's suddenly a need to spend some time on the phone, there's other people in the clinic, if you don't have a nurse specialist that has some time to do that you really are a bit stuck. I think it's embarrassing when you have to stop and say I can't, I can't do any more in clinic, go back to the GP, go back to the social worker …’. (Focus group, P6) | |
| Recognition that the effects of ILD permeate all domains of life | ‘I mean the tool itself is … actually trying to make sure that the, all the kind of concerns and the domains they might have been covered and identified and referred to the right people, that somebody is dealing with it …’. (Expert group, P2) | |
| Communication† | Unprepared/lacking in skills to explore some areas, eg, spiritual dimension | ‘If I was going to tick a box, box about spiritual or existential concerns related to any of those points … I wouldn't have a first clue what to do about that, …’ ‘…we're really good at looking for the things we think we can do something about …’. (Expert group, P3) |
| NAT:ILD benefits for patients and services* | Tool is a clear, useful ‘aide-memoire’ to ask and then ensure action to address concerns and thus improve care | ‘I mean the tool itself is broader than just [trying to manage] the unscheduled admissions … actually trying to make sure that the, all the kind of concerns and the domains they might have been covered and identified and referred to the right people, that somebody is dealing with it …’. (Focus group, P2) |
| Tool could identify training needs, service development requirements and help optimise use of additional resources | ‘… that gives an idea of what resources you'll need to [address] and commission’. (Expert group, P1) | |
*Increased willingness to use the tool in practice.
†Caused concerns to use the tool in practice, but not seen as insurmountable with training.
ILD, interstitial lung disease; NAT, Needs Assessment Tool.