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基层医疗保健专业人员对肺癌预警症状和体征患者寻求帮助的看法:一项定性研究。

Primary healthcare professionals' perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study.

机构信息

Catherine McAuley School of Nursing and Midwifery, University College Cork, College Road, T12 AK54, Cork, Ireland.

School of Pharmacy, University College Cork, Cork, Ireland.

出版信息

BMC Prim Care. 2022 May 18;23(1):119. doi: 10.1186/s12875-022-01730-x.

Abstract

BACKGROUND

Lung cancer is the leading cause of cancer incidence and mortality worldwide. Prompt patient help-seeking for signs and symptoms suggestive of lung cancer is crucial for early referral, diagnosis, and survivorship. However, individuals with potential lung cancer symptoms tend to delay help-seeking. This qualitative study explored perceived barriers to patient help-seeking and strategies to enhance help-seeking for lung cancer warning signs and symptoms from the perspective of primary healthcare professionals.

METHODS

Semi-structured focus groups and individual interviews were conducted with 36 primary healthcare professionals. Data were collected via videoconferencing. Inductive thematic analysis was conducted.

RESULTS

The following two themes were created from the data: (i) perceived barriers to patient help-seeking for signs and symptoms of concern and (ii) facilitating early patient presentation for signs and symptoms of concern. Some participants believed that the high cost of a general practitioner visit, long waiting times, and previous bad experiences with the healthcare system would deter patients from seeking help for symptoms of lung cancer. Perceived patient-related barriers to help-seeking related to the different emotions associated with a potential cancer diagnosis as well as stigma, embarrassment, and guilt felt by smokers. Sociodemographic factors such as drug use, homelessness, living in rural areas, and being male and older were also perceived to impede patient help-seeking. The negative impact of the COVID-19 pandemic on cancer help-seeking also featured strongly. Participants recommended several strategies to enable patients to seek help for symptoms of concern including targeted educational campaigns focussing on symptoms (e.g., cough) rather than behaviours (e.g., smoking), accessible and free health services, and using patients' support networks.

CONCLUSIONS

Patient-related and healthcare system-related barriers to help-seeking for lung cancer warning signs and symptoms include cost of healthcare, cancer fear, and various sociodemographic factors. Participants suggested that increased awareness and early patient help-seeking for symptoms of concern could be achieved through targeted patient education, national campaigns, the use of community support networks, and free and accessible targeted screening services.

摘要

背景

肺癌是全球癌症发病率和死亡率的主要原因。对于早期转介、诊断和生存,及时帮助有肺癌可疑症状的患者寻求帮助至关重要。然而,有潜在肺癌症状的个体往往会延迟寻求帮助。本定性研究从初级保健专业人员的角度探讨了患者寻求肺癌预警症状帮助的障碍以及增强这些症状帮助寻求的策略。

方法

对 36 名初级保健专业人员进行了半结构式焦点小组和个人访谈。通过视频会议收集数据。采用归纳主题分析。

结果

从数据中创建了以下两个主题:(i)对关注症状患者寻求帮助的感知障碍,(ii)促进关注症状患者的早期就诊。一些参与者认为,全科医生就诊费用高、等待时间长、以前对医疗保健系统的不良体验会阻止患者因肺癌症状寻求帮助。与帮助寻求相关的感知患者相关障碍与潜在癌症诊断相关的不同情绪以及吸烟者感到的耻辱、尴尬和内疚有关。社会人口因素,如吸毒、无家可归、居住在农村地区、男性和年龄较大,也被认为会阻碍患者寻求帮助。COVID-19 大流行对癌症寻求帮助的负面影响也非常突出。参与者建议了一些策略,以使患者能够因关注的症状而寻求帮助,包括针对症状(例如咳嗽)而不是行为(例如吸烟)的有针对性的教育活动、提供便利和免费的健康服务以及利用患者的支持网络。

结论

对肺癌预警症状的帮助寻求的患者相关和医疗保健系统相关障碍包括医疗保健费用、癌症恐惧和各种社会人口因素。参与者认为,可以通过有针对性的患者教育、国家宣传活动、利用社区支持网络以及提供免费和便利的针对性筛查服务,提高对症状的认识并鼓励早期寻求帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/9115917/60b9065661ca/12875_2022_1730_Fig1_HTML.jpg

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