WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia.
Eur J Cancer Care (Engl). 2012 Mar;21(2):259-65. doi: 10.1111/j.1365-2354.2011.01314.x. Epub 2011 Dec 6.
The aim of this study was to assess general practitioner (GP) consultations with standardised patients presenting with cancer-related problems that might benefit from radiotherapy. Standardised patient scenarios were constructed with indications for radiotherapy or with side effects of radiotherapy. Six GPs consulted six standardised patients. All consultations were video recorded. Two GPs independently rated the consultation performance using the Leicester Assessment Package (LAP). Each consultation was also assessed by two radiation oncologists to assess specific decisions taken or advice offered to 'patients' in each case. The mean duration of consultations was 13 min and 55 s. Three GPs differed significantly (P < 0.025) in competencies measured by the LAP, but not as assessed by radiation oncologists. There was no significant difference in LAP scores when reviewed by scenario. However, there was significant differences in the management of the case with prostate cancer (P= 0.005) and data suggest that GPs management of different problems presented varied widely. These data are consistent with the published literature which suggests that in practice not all patients are appropriately advised or referred. There is a need for innovations to support GPs to manage patients who would benefit from radiotherapy.
本研究旨在评估全科医生（GP）与可能受益于放射治疗的癌症相关问题的标准化患者的就诊情况。标准化患者场景的构建具有放射治疗的适应症或放射治疗的副作用。六位 GP 为六位标准化患者提供咨询。所有咨询均进行了视频记录。两位 GP 使用莱斯特评估包（LAP）独立评估了咨询表现。每位咨询还由两位放射肿瘤学家进行评估，以评估每位患者的具体决策或建议。咨询的平均持续时间为 13 分钟 55 秒。三位 GP 在 LAP 测量的能力方面存在显著差异（P < 0.025），但放射肿瘤学家评估结果并非如此。根据场景审查，LAP 评分没有显著差异。然而，在前列腺癌病例的管理方面存在显著差异（P= 0.005），数据表明，GP 对不同问题的处理差异很大。这些数据与已发表的文献一致，表明在实践中，并非所有患者都得到了适当的建议或转介。需要创新措施来支持 GP 管理那些受益于放射治疗的患者。
