Halkett G K B, Jiwa M, Lobb E A
School of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Department of Medical Education, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Eur J Cancer Care (Engl). 2015 Sep;24(5):662-72. doi: 10.1111/ecc.12224. Epub 2014 Aug 6.
The aim of this study was to explore patients' perspectives on the role of their general practitioner (GP) after an advanced cancer diagnosis. A qualitative research approach was used. Semi-structured interviews were conducted and data were analysed using a constant comparative methodology. Participants were eligible if they were diagnosed with advanced cancer and referred for palliative radiotherapy. Data saturation was achieved after 21 interviews. Key themes included (1) obtaining diagnosis and referral for advanced cancer treatment; (2) preference for specialist oncology care; (3) a preference for GP to act as an advocate; and (4) obtaining ongoing routine care from their GP. GP involvement in the patients' management was dependent on: time since diagnosis, GP's involvement in diagnosis and referral, doctor/patient relationship, additional chronic conditions requiring management, frequency of seeing oncologist and specialist recommendation to involve GP. Patients want GPs to have varying levels of involvement following an advanced cancer diagnosis. Not all communication between GPs and patients was positive suggesting communication skills training may be a priority. Patients wished to maintain continunity of care for their non-cancer related issues and healthcare of their family members. Future research needs to focus on working with GPs to increase their role in the management of advanced cancer.
本研究的目的是探讨患者在被诊断为晚期癌症后,对其全科医生(GP)角色的看法。采用了定性研究方法。进行了半结构化访谈,并使用持续比较法对数据进行了分析。如果参与者被诊断为晚期癌症并被转诊接受姑息性放疗,则符合条件。在进行了21次访谈后达到了数据饱和。关键主题包括:(1)获得晚期癌症治疗的诊断和转诊;(2)对肿瘤专科护理的偏好;(3)希望全科医生充当倡导者;(4)从全科医生那里获得持续的常规护理。全科医生对患者管理的参与程度取决于:诊断后的时间、全科医生在诊断和转诊中的参与程度、医患关系、需要管理的其他慢性疾病、看肿瘤医生的频率以及肿瘤医生建议全科医生参与的情况。患者希望在被诊断为晚期癌症后,全科医生的参与程度有所不同。全科医生与患者之间并非所有的沟通都是积极的,这表明沟通技能培训可能是一个优先事项。患者希望在非癌症相关问题以及家庭成员的医疗保健方面保持护理的连续性。未来的研究需要专注于与全科医生合作,以增加他们在晚期癌症管理中的作用。