MBBS Program School of Medicine, Ipswich Campus, The University of Queensland, Brisbane, Australia.
Health Soc Care Community. 2012 Nov;20(6):607-16. doi: 10.1111/j.1365-2524.2012.01075.x. Epub 2012 Jul 17.
Effective cancer care depends on inter-sectoral and inter-professional communication. General Practitioners (GPs) play a pivotal role in managing the health of most Australians, but their role in cancer care is unclear. This qualitative study explored GPs' views of this role and factors influencing their engagement with cancer care. Twelve metropolitan and non-metropolitan GPs in Queensland, Australia, were recruited between April and May 2008, and three focus groups and one interview were conducted using open-ended questions. The transcripts were analysed thematically. The first theme, GPs' perceptions of their role, comprised subthemes corresponding to four phases of the trajectory. The second theme, Enhancing GPs' involvement in ongoing cancer care, comprised subthemes regarding enhanced communication and clarification of roles and expectations. GPs' role in cancer care fluctuates between active advocacy during diagnosis and palliation, and ambivalent redundancy in between. The role is influenced by socioeconomic, clinical and geographical factors, patients' expectations and GPs' motivation. Not all participants wanted an enhanced role in cancer care, but all valued better specialist-GP communication. Role clarification is needed, together with greater mutual trust between GPs and specialists. Key needs included accessible competency training and mentoring for doctors unfamiliar with the system. Existing system barriers and workforce pressures in general practice must be addressed to improve the sharing of cancer care. Only one metropolitan focus group was conducted, so saturation of themes may not have been reached. The challenges of providing cancer care in busy metropolitan practices are multiplied in non-metropolitan settings with less accessible resources and where distance affects specialist communication. Non-metropolitan GPs learn from experience how to overcome referral and communication challenges. While the GPs identified solutions to their concerns, the role can be daunting. GPs are motivated to provide long-term care for their patients, but need to be acknowledged and supported by the health system.
有效的癌症护理取决于跨部门和跨专业的沟通。全科医生（GP）在管理大多数澳大利亚人的健康方面发挥着关键作用，但他们在癌症护理中的角色并不明确。这项定性研究探讨了全科医生对这一角色的看法，以及影响他们参与癌症护理的因素。2008 年 4 月至 5 月，澳大利亚昆士兰州招募了 12 名大都市和非大都市的全科医生，并通过开放式问题进行了三次焦点小组和一次访谈。对转录本进行了主题分析。第一个主题是全科医生对其角色的看法，包括与轨迹的四个阶段相对应的子主题。第二个主题是“增强全科医生在持续癌症护理中的参与度”，包括增强沟通以及澄清角色和期望的子主题。全科医生在癌症护理中的角色在诊断和姑息治疗期间积极倡导与两者之间的矛盾冗余之间波动。该角色受社会经济、临床和地理因素、患者期望和全科医生的动机的影响。并非所有参与者都希望在癌症护理中扮演更积极的角色，但所有人都重视更好的专科医生-全科医生沟通。需要明确角色，同时增强全科医生和专科医生之间的相互信任。关键需求包括为不熟悉该系统的医生提供可访问的能力培训和指导。必须解决一般实践中现有的系统障碍和劳动力压力，以改善癌症护理的共享。仅进行了一次大都市焦点小组，因此主题的饱和度可能尚未达到。在资源更难以获得且距离影响专家沟通的非大都市环境中，在繁忙的大都市实践中提供癌症护理的挑战会增加。非大都市的全科医生从经验中学习如何克服转诊和沟通挑战。虽然全科医生确定了解决其问题的方案，但该角色可能令人生畏。全科医生有动力为患者提供长期护理，但需要得到卫生系统的认可和支持。
