Research Department of Behavioural Science and Health, University College London, London.
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University, London.
Br J Gen Pract. 2018 May;68(670):e333-e341. doi: 10.3399/bjgp18X695741. Epub 2018 Mar 26.
Safety netting is an important diagnostic strategy for patients presenting to primary care with potential (low-risk) cancer symptoms. Typically, this involves asking patients to return if symptoms persist. However, this relies on patients re-appraising their symptoms and making follow-up appointments, which could contribute to delays in diagnosis. Text messaging is increasingly used in primary care to communicate with patients, and could be used to improve safety netting.
To explore the acceptability and feasibility of using text messages to safety net patients presenting with low-risk cancer symptoms in GP primary care (txt-netting).
Qualitative focus group and interview study with London-based GPs.
Participants were identified using convenience sampling methods. Five focus groups and two interviews were conducted with 22 GPs between August and December 2016. Sessions were audiorecorded, transcribed verbatim, and analysed using thematic analysis.
GPs were amenable to the concept of using text messages in cancer safety netting, identifying it as an additional tool that could help manage patients and promote symptom awareness. There was wide variation in GP preferences for text message content, and a number of important potential barriers to txt-netting were identified. Concerns were raised about the difficulties of conveying complex safety netting advice within the constraints of a text message, and about confidentiality, widening inequalities, and workload implications.
Text messages were perceived to be an acceptable potential strategy for safety netting patients with low-risk cancer symptoms. Further work is needed to ensure it is cost-effective, user friendly, confidential, and acceptable to patients.
对于因潜在（低风险）癌症症状而到初级保健机构就诊的患者，安全网策略是一种重要的诊断策略。通常，这包括要求患者如果症状持续存在则返回。但是，这取决于患者重新评估其症状并进行后续预约，这可能导致诊断延迟。短信在初级保健中越来越多地用于与患者进行沟通，并且可以用于改善安全网。
探索使用短信对在普通科医生初级保健中出现低风险癌症症状的患者进行安全网（txt-netting）的可接受性和可行性。
使用伦敦普通科医生的定性焦点小组和访谈研究。
使用便利抽样方法确定参与者。2016 年 8 月至 12 月，对 22 名普通科医生进行了五次焦点小组和两次访谈。会议进行了录音，并逐字转录，然后使用主题分析进行了分析。
普通科医生对使用短信进行癌症安全网的概念持开放态度，认为这是一种可以帮助管理患者和促进症状意识的附加工具。普通科医生对短信内容的偏好存在很大差异，并确定了一些 txt-netting 的潜在重要障碍。人们对在短信的限制内传达复杂的安全网建议的困难表示担忧，还对保密性、扩大不平等和工作量影响表示担忧。
短信被认为是一种可接受的潜在策略，可用于对低风险癌症症状的患者进行安全网。需要进一步的工作，以确保其具有成本效益、用户友好、保密且被患者接受。
