The Research Unit for General Practice and Section for General Medical Practice, School of Public Health, Aarhus University, Denmark.
Br J Gen Pract. 2011 May;61(586):e215-22. doi: 10.3399/bjgp11X572409.
General practice plays an important role in the cancer care pathway. The initial diagnostic phase may be crucial for the relationship between the patient and the GP.
The aim was to describe whether patients' confidence in their GP changed after a cancer diagnosis, and analyse whether the change in confidence was associated with doctor delay.
Population-based cohort study with 1892 questionnaires sent to patients and their GPs in general practices in the former Aarhus County, Denmark.
Information on patients' confidence in their GP was obtained from the patient questionnaire. Information on doctor delay was obtained from the GPs and defined as a period of 14 days or more from the date of first symptom presentation to the GP until cancer-specific investigation was initiated.
Before the cancer diagnosis, 88.4% of the patients had confidence in their GP, which decreased to 80.0% after the diagnosis (P<0.001); 15.8% of the patients who experienced no doctor delay reported a decrease in confidence after the cancer diagnosis, compared with 29.1% of the patients with a doctor delay (P<0.001). Patients presenting with alarm symptoms and experiencing doctor delay were 3.8 times more likely to lose confidence compared with those presenting with alarm symptoms who experienced no doctor delay (P = 0.048).
The majority of the patients had high levels of confidence in their GP before, as well as after, the cancer diagnosis. Nevertheless, a substantial amount had low confidence in the GP, especially when experiencing doctor delay in the initial phase of the pathway.
全科医生在癌症治疗途径中起着重要作用。初始诊断阶段对于患者和全科医生之间的关系可能至关重要。
本研究旨在描述癌症诊断后患者对全科医生的信心是否发生变化，并分析信心变化是否与医生延迟有关。
这是一项基于人群的队列研究，向丹麦前奥胡斯郡的普通诊所的 1892 名患者及其全科医生发送了调查问卷。
患者信心的信息来自患者问卷，医生延迟的信息来自全科医生，定义为从首次出现症状到全科医生开始进行癌症特异性检查的 14 天或更长时间。
在癌症诊断之前，88.4%的患者对全科医生有信心，诊断后降至 80.0%（P<0.001）；15.8%无医生延迟的患者报告诊断后信心下降，而有医生延迟的患者为 29.1%（P<0.001）。出现报警症状且经历医生延迟的患者与出现报警症状且无医生延迟的患者相比，失去信心的可能性高 3.8 倍（P = 0.048）。
大多数患者在癌症诊断前后对全科医生都有很高的信心。然而，仍有相当一部分患者对全科医生的信心较低，尤其是在治疗途径的初始阶段经历医生延迟时。
