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“癌症患者不再找我看病了”——全科医生在癌症患者早期随访中的作用——一项定性研究

"When patients have cancer, they stop seeing me"--the role of the general practitioner in early follow-up of patients with cancer--a qualitative study.

作者信息

Anvik Tor, Holtedahl Knut A, Mikalsen Hege

机构信息

Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway.

出版信息

BMC Fam Pract. 2006 Mar 21;7:19. doi: 10.1186/1471-2296-7-19.

Abstract

BACKGROUND

The role of the general practitioner (GP) in cancer follow-up is poorly defined. We wanted to describe and analyse the role of the GP during initial follow-up of patients with recently treated cancer, from the perspective of patients, their relatives and their GPs.

METHODS

One focus group interview with six GPs from the city of Bodø and individual interviews with 17 GPs from the city of Tromsø in North Norway. Text analysis of the transcribed interviews and of free text comments in two questionnaires from 91 patients with cancer diagnosed between October 1999 and September 2000 and their relatives from Tromsø.

RESULTS

The role of the GP in follow-up of patients with recently treated cancer is discussed under five main headings: patient involvement, treating the cancer and treating the patient, time and accessibility, limits to competence, and the GP and the hospital should work together.

CONCLUSION

The GP has a place in the follow-up of many patients with cancer, also in the initial phase after treatment. Patients trust their GP to provide competent care, especially when they have more complex health care needs on top of their cancer. GPs agree to take a more prominent role for cancer patients, provided there is good access to specialist advice. Plans for follow-up of individual patients could in many cases improve care and cooperation. Such plans could be made preferably before discharge from in-patient care by a team consisting of the patient, a carer, a hospital specialist and a general practitioner. Patients and GPs call on hospital doctors to initiate such collaboration.

摘要

背景

全科医生(GP)在癌症随访中的作用界定不清。我们希望从患者、其亲属以及全科医生的角度,描述和分析全科医生在近期接受治疗的癌症患者初始随访期间的作用。

方法

对来自博德市的6名全科医生进行了一次焦点小组访谈,并对来自挪威北部特罗姆瑟市的17名全科医生进行了个人访谈。对转录访谈以及1999年10月至2000年9月期间确诊的91名特罗姆瑟市癌症患者及其亲属的两份问卷中的自由文本评论进行了文本分析。

结果

在以下五个主要标题下讨论了全科医生在近期接受治疗的癌症患者随访中的作用:患者参与、治疗癌症与治疗患者、时间与可及性、能力限制以及全科医生与医院应协同工作。

结论

全科医生在许多癌症患者的随访中占有一席之地,在治疗后的初始阶段也是如此。患者信任他们的全科医生提供胜任的护理,尤其是当他们除了癌症之外还有更复杂的医疗需求时。如果能方便地获得专科医生的建议,全科医生同意在癌症患者的随访中发挥更突出的作用。在许多情况下,针对个体患者的随访计划可以改善护理与合作。此类计划最好在患者出院前由患者、护理人员、医院专科医生和全科医生组成的团队制定。患者和全科医生呼吁医院医生发起这种合作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f21f/1435903/b6d007f9c644/1471-2296-7-19-1.jpg

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