Table 1 Topic guide for healthcare professional focus groups

Introduction

Introduce Research

Looking at how to make it easier to manage symptoms in advanced cancer patients

• Introduce self

• Explain confidentiality, length of interview/group, nature of discussion

• What we are going to cover

• Any questions?

• Obtain consent

• Start recording

• Participants invited to introduce themselves

Assessing and managing challenging symptoms

How do you manage

Pain

Breathlessness

Fatigue

• Can you talk me through your approach to managing each of these symptoms? (Card sort exercise).

• How do you decide what to do? (guidelines?)

• How consistent is the approach to managing these symptoms in your workplace?

• How often are you completely satisfied that the patients symptoms are optimally controlled?

• Most/least confident managing?

Which is the most severe and which has the biggest impact on quality of life

Example of good experience and possible facilitators

Can you think of a situation when you were able to manage one or more of these symptoms well

• How would you describe the experience? How did this make you/patient/carers feel

• Why was it that in this case you were able to manage the symptom well?

What/who helped you?

Example of poor experience and possible barriers

Can you think of a situation when you were not able to manage one or more of these symptoms so well

• How would you describe the experience? How did this make you/patient/carers feel

• Why do you think that in this case it was not possible to manage the symptom well?

• What made it so difficult?

• Who else can you ask for help if the symptom cannot be controlled?

• Who might you work with? Other in same role/nurse/doctor/pharmacist/complementary therapist/ physiotherapist?

• What do you think could be done (in an ideal world) to make management of these symptoms more successful more often

Closing