Easley J, Miedema B, O'Brien M A, Carroll J, Manca D, Webster F, Grunfeld E
Dalhousie University, Family Medicine Teaching Unit, Fredericton, NB.
University of Toronto, Department of Family and Community Medicine, and.
Curr Oncol. 2017 Apr;24(2):75-80. doi: 10.3747/co.24.3447. Epub 2017 Apr 27.
Currently, the specific role of family physicians (fps) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of fps.
Using a constructivist grounded theory approach, we conducted telephone interviews with 58 primary and cancer specialist health care providers from across Canada.
The participants-21 fps, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology-were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum. Participants identified 3 key roles: coordinating cancer care, managing comorbidities, and providing psychosocial care to patients and their families. However, fps and specialists discussed many challenges that prevent fps from fully performing those roles: ■ The fps described communication problems resulting from not being kept "in the loop" because they weren't copied on patient reports and also the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients.■ The specialists expressed concerns about a lack of patient access to fp care, leaving specialists to fill the care gaps. The fps and specialists both recommended additional training and education for fps in survivorship care, cancer screening, genetic testing, and new cancer treatments.
Better communication, more collaboration, and further education are needed to enhance the role of fps in the care of cancer patients.
目前，家庭医生在癌症患者护理中的具体作用尚未明确界定。我们的目标是探讨医生对于癌症护理协调及家庭医生作用的观点和相关背景因素。
我们采用建构主义扎根理论方法，对来自加拿大各地的58名初级和癌症专科医疗服务提供者进行了电话访谈。
参与者包括21名家庭医生、15名外科医生、12名肿瘤内科医生、6名放射肿瘤学家和4名肿瘤专科全科医生，他们被要求描述家庭医生目前所扮演的角色以及他们认为家庭医生在癌症患者整个连续护理过程中未来应扮演的角色。参与者确定了三个关键角色：协调癌症护理、管理合并症以及为患者及其家属提供心理社会护理。然而，家庭医生和专科医生讨论了许多阻碍家庭医生充分履行这些角色的挑战：
■ 家庭医生表示，由于未收到患者报告副本而未被“纳入流程”，导致沟通问题，并且参与癌症患者护理的所有不同医疗服务提供者的角色缺乏明确界定。
■ 专科医生对患者难以获得家庭医生护理表示担忧，这使得专科医生不得不填补护理缺口。家庭医生和专科医生都建议为家庭医生提供关于癌症幸存者护理、癌症筛查、基因检测和新癌症治疗方面的额外培训和教育。
需要更好的沟通、更多的协作以及进一步的教育来加强家庭医生在癌症患者护理中的作用。
