Jaafar F, Davison A G, Beaty T, Eraut C D, Haque A S, Lamont A, Trask C W
Southend Associate University Hospital, Southend on Sea, Essex SSO ORY, UK.
Lung Cancer. 2004 Oct;46(1):57-9. doi: 10.1016/j.lungcan.2004.03.014.
Multidisciplinary teams (MDT) now review all cases of lung cancer. These teams include a Lung Cancer Nurse Specialist (LCNS). These Nurses help support the patient and should facilitate communication and liaise with other services. The LCNS is present when the diagnosis is given to the patient but also usually spends time afterwards with the patient and their family. We postulated that a separate letter from the LCNS to the General Practitioner (GP) after the consultations would convey extra information to the GP. In 58 new lung cancer patients reviewed in the clinic, the LCNS and Physician independently wrote separate letters after the consultation in which the diagnosis of lung cancer was given. The GPs were asked by questionnaire about the usefulness of the letter from the LCNS. This letter was considered by the GP to provide extra information in: (i) 69% concerning the patients reaction to the diagnosis; (ii) 85% concerning who attended the clinic with the patient; (iii) 85% about what referrals were made to community services; (iv) 86% about who the patient was living with; (v) 81% about who the patients carers were; (vi) 81% information on the patients condition; (vii) 70% concerning the information given to patients about benefits. Ninety-seven percent of the GPs found the LCNS letter useful or very useful and 92% of the GPs thought that the information in the letter would be useful or very useful when they next saw the patient. Separate and independent letters from the LCNS after "bad news" consultation in lung cancer provides added useful information for GPs. Ninety-one percent of the GPs wanted the letters from the LCNS to continue.
多学科团队（MDT）现在会对所有肺癌病例进行评估。这些团队包括肺癌专科护士（LCNS）。这些护士为患者提供支持，并应促进沟通以及与其他服务部门进行联络。当向患者告知诊断结果时，肺癌专科护士会在场，而且通常在之后还会花时间陪伴患者及其家人。我们推测，会诊后由肺癌专科护士单独给全科医生（GP）写一封信，会向全科医生传达额外信息。在诊所评估的58例新发肺癌患者中，肺癌专科护士和医生在给出肺癌诊断的会诊后分别独立撰写了一封信。通过问卷调查询问全科医生关于肺癌专科护士信件的有用性。全科医生认为这封信在以下方面提供了额外信息：（i）69%涉及患者对诊断的反应；（ii）85%涉及谁陪同患者就诊；（iii）85%涉及向社区服务机构进行了哪些转诊；（iv）86%涉及患者与谁同住；（v）81%涉及患者的护理人员是谁；（vi）81%关于患者病情的信息；（vii）70%涉及向患者提供的关于福利的信息。97%的全科医生认为肺癌专科护士的信有用或非常有用，92%的全科医生认为信中的信息在他们下次见到患者时会有用或非常有用。肺癌“坏消息”会诊后由肺癌专科护士单独撰写的独立信件为全科医生提供了额外的有用信息。91%的全科医生希望继续收到肺癌专科护士的信件。
