Table 1.

Topic guide for healthcare professional focus groups

Section	General Question	Prompt items
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	Thank you for your participation