Background
Recently, we conducted a large longitudinal multicenter study on the preferences for information and for participation in medical decisionmaking of advanced lung cancer patients and the degree to which these preferences were met according to the patient.
The results showed that patients’ information and participation preferences were often not met. More specifically, a lot of patients who wanted information about their prognosis, palliative care and end-of-life decisions shortly after the diagnosis of advanced cancer reported they were not informed. Patients who wanted to make the medical decisions together with their
physician (i.e., shared decisionmaking) often did not achieve this and were less involved than they wanted to be.

Objectives
The first goal of this study is to discuss these communication problems with oncologists and to list their suggestions for improvement. The second goal is to develop a specific intervention that improves physicianpatient communication at the end of life and, more specifically, informationgiving and patient participation in medical decision-making in correspondence with the patients' preferences.

Methods
We will use the methodology of the focus group. The focus group is a qualitative research method for eliciting descriptive data from population subgroups. Three focus groups with physicians treating seriously ill patients will be held. Sessions will be audio-taped, transcribed, and analyzed through systematic coding and comparing and contrasting themes.