Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Center for Shared Decision Making, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
BMJ Open. 2021 May 5;11(5):e043038. doi: 10.1136/bmjopen-2020-043038.
Shared care models in the field of cancer aim to improve care coordination, role clarification and patient satisfaction. Cross-sectoral communication is pivotal. Involvement of patients may add to intended mechanisms.A randomised controlled trial 'The Partnership Study' tested the effect of bringing together patient, general practitioner (GP) and oncologist for a consultation conducted by video.
As part of the process evaluation, this study aimed to explore experiences, attitudes and perspectives of the oncological department on sharing patient consultations with GPs using video.
Four semistructured interviews with five oncologists and four nurse specialists were conducted in February 2020. We focused on the informants' experiences and reflections on the potential of future implementation of the concept 'inviting the GP for a shared consultation by video'. The analyses were based on an inductive, open-minded, hermeneutic phenomenological approach.
A total of six overall themes were identified: structuring consultation and communication, perceptions of GP involvement in cancer care, stressors, making a difference, alternative ways of cross-sector communication and needs for redesigning the model. The concept made sense and was deemed useful, but solving the many technical and organisational problems is pivotal. Case-specific tasks and relational issues were targeted by pragmatically rethinking protocol expectations and the usual way of communication and structuring patient encounters. Case selection was discussed as one way of maturing the concept.
This Danish study adds new insight into understanding different aspects of the process, causal mechanisms as well as the potential of future implementation of video-based tripartite encounters. Beyond solving the technical problems, case selection and organisational issues are important. Acknowledging the disruption of the usual workflow, the introduction of new phases of the usual encounter and the variety of patient-GP relationships to be embraced may help to better understand and comply with barriers and facilitators of communication and sharing.
NCT02716168.
作为过程评估的一部分，本研究旨在探讨肿瘤学部门对通过视频与全科医生共享患者咨询的经验、态度和观点。
2020 年 2 月，对 5 名肿瘤学家和 4 名护士专家进行了 4 次半结构化访谈。我们专注于受访者对未来实施“通过视频邀请全科医生进行共同咨询”这一概念的潜力的经验和思考。分析基于一种归纳式、开放的、解释学的现象学方法。
共确定了 6 个总体主题：咨询和沟通的结构、对全科医生参与癌症护理的看法、压力源、产生影响、跨部门沟通的替代方式和模型重新设计的需求。这一概念有意义且被认为是有用的，但解决许多技术和组织问题是关键。通过重新思考协议期望和通常的沟通和患者就诊结构方式，针对特定病例的任务和关系问题，以务实的方式解决问题。病例选择被讨论为完善这一概念的一种方式。
这项丹麦研究为理解视频为基础的三方接触的过程、因果机制以及未来实施的潜力提供了新的见解。除了解决技术问题外，病例选择和组织问题也很重要。承认通常工作流程的中断、引入通常就诊的新阶段以及需要接受各种医患关系，可能有助于更好地理解和遵守沟通和共享的障碍和促进因素。
NCT02716168。
