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预防癌症延迟诊断:临床医生对主要问题及解决方案的看法。

Preventing delayed diagnosis of cancer: clinicians' views on main problems and solutions.

作者信息

Car Lorainne Tudor, Papachristou Nikolaos, Urch Catherine, Majeed Azeem, El-Khatib Mona, Aylin Paul, Atun Rifat, Car Josip, Vincent Charles

机构信息

Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK.

Imperial College Healthcare NHS Trust, ‎St Mary's Hospital, London, UK.

出版信息

J Glob Health. 2016 Dec;6(2):020901. doi: 10.7189/jogh.06.020901.

Abstract

BACKGROUND

Delayed diagnosis is a major contributing factor to the UK's lower cancer survival compared to many European countries. In the UK, there is a significant national variation in early cancer diagnosis. Healthcare providers can offer an insight into local priorities for timely cancer diagnosis. In this study, we aimed to identify the main problems and solutions relating to delay cancer diagnosis according to cancer care clinicians.

METHODS

We developed and implemented a new priority-setting approach called PRIORITIZE and invited North West London cancer care clinicians to identify and prioritize main causes for and solutions to delayed diagnosis of cancer care.

RESULTS

Clinicians identified a number of concrete problems and solutions relating to delayed diagnosis of cancer. Raising public awareness, patient education as well as better access to specialist care and diagnostic testing were seen as the highest priorities. The identified suggestions focused mostly on the delays during referrals from primary to secondary care.

CONCLUSIONS

Many identified priorities were feasible, affordable and converged around common themes such as public awareness, care continuity and length of consultation. As a timely, proactive and scalable priority-setting approach, PRIORITZE could be implemented as a routine preventative system for determining patient safety issues by frontline staff.

摘要

背景

与许多欧洲国家相比,诊断延迟是英国癌症生存率较低的一个主要促成因素。在英国,早期癌症诊断存在显著的全国性差异。医疗服务提供者可以深入了解当地及时进行癌症诊断的优先事项。在本研究中,我们旨在根据癌症护理临床医生确定与癌症诊断延迟相关的主要问题和解决方案。

方法

我们开发并实施了一种名为PRIORITIZE的新的优先事项确定方法,并邀请伦敦西北部的癌症护理临床医生确定癌症护理诊断延迟的主要原因和解决方案,并对其进行优先级排序。

结果

临床医生确定了一些与癌症诊断延迟相关的具体问题和解决方案。提高公众意识、患者教育以及更好地获得专科护理和诊断检测被视为最优先事项。确定的建议主要集中在从初级护理转诊到二级护理期间的延迟。

结论

许多确定的优先事项是可行的、经济实惠的,并且围绕公众意识、护理连续性和会诊时长等共同主题展开。作为一种及时、主动且可扩展的优先事项确定方法,PRIORITZE可作为一线工作人员确定患者安全问题的常规预防系统来实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c55/5140077/86dca21319d8/jogh-06-020901-F1.jpg

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