Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
Scand J Prim Health Care. 2022 Mar;40(1):11-28. doi: 10.1080/02813432.2022.2036421. Epub 2022 Mar 7.
General practice plays an important role in cancer trajectories, and cancer patients request the continuous involvement of general practice. The objective of this scoping review was to identify healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective.
DESIGN, SETTING, AND SUBJECTS: A scoping review of the literature published in Danish or English from 2010 to 2020 was conducted. Data was collected using identified keywords and indexed terms in several databases (PubMed, MEDLINE, EBSCO CINAHL, Scopus, and ProQuest), contacting key experts, searching through reference lists, and reports from selected health political, research- and interest organizations' websites.
We identified healthcare practices in cancer trajectories that increase quality care. Identified healthcare practices were grouped into four contextual domains and allocated to defined phases in the cancer trajectory. The results are presented according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR).
A total of 45 peer-reviewed and six non-peer-reviewed articles and reports were included. Quality of care increases in all phases of the cancer trajectory when GPs listen carefully to the full story and use action plans. After diagnosis, quality of care increases when GPs and practice staff have a proactive care approach, act as interpreters of diagnosis, treatment options, and its consequences, and engage in care coordination with specialists in secondary care involving the patient.
This scoping review identified healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective. The results support general practice in investigating own healthcare practices and identifying possibilities for quality improvement.KEY POINTSIdentified healthcare practices in general practice that increase the quality of care in cancer trajectories:Listen carefully to the full storyUse action plans and time-out-consultationsPlan and provide proactive careAct as an interpreter of diagnosis, treatment options, and its consequences for the patientCoordinate care with specialists, patients, and caregivers with mutual respectIdentified barriers for quality of care in cancer trajectories are:Time constraints in consultationsLimited accessibility for patients and caregiversHealth practices to increase the quality of care should be effective, safe, people-centered, timely, equitable, integrated, and efficient. These distinctions of quality of care, support general practice in investigating and improving quality of care in cancer trajectories.
全科医学在癌症病程中起着重要作用，癌症患者要求全科医学的持续参与。本综述的目的是从全科医学的角度确定提高癌症病程中护理质量的医疗实践。
设计、地点和对象：对 2010 年至 2020 年期间在丹麦语或英语发表的文献进行了范围综述。使用几个数据库（PubMed、MEDLINE、EBSCO CINAHL、Scopus 和 ProQuest）中确定的关键词和索引词、联系关键专家、通过参考文献列表和选定的卫生政治、研究和利益组织网站上的报告收集数据。
我们确定了提高癌症病程中护理质量的医疗实践。确定的医疗实践被分为四个背景领域，并分配到癌症病程的定义阶段。结果根据系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）进行呈现。
共纳入 45 篇同行评议和 6 篇非同行评议的文章和报告。当全科医生仔细倾听完整的故事并使用行动计划时，癌症病程的所有阶段的护理质量都会提高。诊断后，当全科医生和实践工作人员采取积极主动的护理方法、充当诊断、治疗方案及其后果的解释者以及与二级保健专家合作协调涉及患者的护理时，护理质量会提高。
本综述确定了从全科医学角度提高癌症病程中护理质量的医疗实践。结果支持全科医生调查自身医疗实践并确定质量改进的可能性。
提高癌症病程中护理质量的全科医疗实践：仔细倾听完整的故事使用行动计划和超时咨询计划并提供积极主动的护理充当患者的诊断、治疗方案及其后果的解释者协调与专家、患者和护理人员的护理，相互尊重确定癌症病程中护理质量的障碍是：咨询时间有限患者和护理人员的可及性有限提高护理质量的健康实践应该是有效、安全、以人为主、及时、公平、综合和有效的。这些护理质量的区别，支持全科医生在调查和改善癌症病程中的护理质量。
