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谁来负责?家庭医生在提供癌症支持性照护中的作用。

Who is responsible? The role of family physicians in the provision of supportive cancer care.

机构信息

St Joseph's Health System Research Network; the Supportive Care Research Unit, Juravinski Cancer Centre; and the Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Oncol Pract. 2010 Jan;6(1):19-24. doi: 10.1200/JOP.091060. Epub 2009 Dec 23.

Abstract

PURPOSE

Patients living with cancer identify family physicians (FPs; ie, primary care physicians) as a preferred resource for supportive cancer care (SCC), either through direct provision or referral. However, little research exists on the specific role FPs play in addressing these needs.

METHODS

A mailed survey was sent to all FPs in a health care region in Ontario, Canada, to determine their current and preferred roles in the specific provision of SCC to patients with cancer who have been newly diagnosed or are at the end of life.

RESULTS

Completed surveys were received from 84 (64%) of 183 eligible FPs. Most practitioners reported providing for their patients' various SCC needs. However, clear gaps were demonstrated in psychosocial and nutritional counseling and in providing information about SCC services. FPs were satisfied with their current role reported in SCC coordination, although the type of role varied; FPs who were asked about their end-of-life patients tended to see themselves as part of coordinating teams, whereas FPs asked about their recently diagnosed patients were more likely to defer this responsibly to a third party.

CONCLUSION

This study identified gaps in the provision of psychosocial and informational care to patients with cancer that may result in unmet needs. In general, FPs do not see themselves as primarily responsible for coordinating patients' SCC and do not wish to assume this role. Accordingly, models that involve FPs as team members in SCC coordination are more feasible for reducing patient need.

摘要

目的

癌症患者将家庭医生(FP;即初级保健医生)视为支持性癌症护理(SCC)的首选资源,无论是通过直接提供还是转介。然而,关于 FP 在满足这些需求方面所扮演的具体角色的研究甚少。

方法

向加拿大安大略省一个医疗区域的所有 FP 邮寄了一份调查,以确定他们在为新诊断或生命末期的癌症患者提供 SCC 方面的当前和首选角色。

结果

从 183 名符合条件的 FP 中收到了 84 份(64%)已完成的调查。大多数医生表示他们为患者的各种 SCC 需求提供了服务。然而,在心理社会和营养咨询以及提供 SCC 服务信息方面存在明显的差距。FP 对他们在 SCC 协调方面的当前角色感到满意,尽管角色类型有所不同;被问及临终患者的 FP 往往认为自己是协调团队的一部分,而被问及最近诊断出的患者的 FP 则更倾向于将这一责任推给第三方。

结论

这项研究发现,癌症患者在接受心理社会和信息咨询方面存在差距,这可能导致需求未得到满足。一般来说,FP 并不认为自己主要负责协调患者的 SCC,也不想承担这一角色。因此,让 FP 作为 SCC 协调团队成员的模式更有利于减少患者的需求。

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