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[加泰罗尼亚地区医疗专业人员对卵巢癌诊断过程中女性经历的看法:定性研究]

[Health professionals' perspective about women's experiences during the diagnostic process of ovarian cancer in Catalonia: Qualitative study].

作者信息

Marzo-Castillejo Mercè, Vela-Vallespín Carmen, Mascort Roca Juanjo, Guiriguet Capdevila Carolina, Codern-Bové Núria, Borras Josep M

机构信息

Unitat Suport a la Recerca Metropolitana Sud, Institut Català de la Salut (ICS); Institut d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Hospitalet de Llobregat, Barcelona, España.

CAP Riu Nord i Riu Sud, Institut Català de la Salut (ICS), Santa Coloma de Gramenet, Barcelona; Unitat Suport a la Recerca Metropolitana Nord, Institut d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Mataró, Barcelona, España.

出版信息

Aten Primaria. 2023 Jun;55(6):102619. doi: 10.1016/j.aprim.2023.102619. Epub 2023 Apr 10.

DOI:10.1016/j.aprim.2023.102619
PMID:37043975
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10119712/
Abstract

OBJECTIVE

To identify missed opportunities in the diagnosis of ovarian cancer (OC) in the public health system of Catalonia, through the analysis of the perceptions of health professionals on the stories's experiences of OC patients.

DESIGN

Qualitative exploratory-descriptive study, with two focus groups.

SETTING

Primary Care, November 2017.

PARTICIPANTS

Thirty-four professionals based on theoretical sampling: 21 family doctors, 8 professionals from sexual and reproductive health centres and 5 hospital gynaecologists.

METHODS

Participants discussed the different diagnostic pathways for women with OC through the presentation of flowcharts which were developed with three storie's and experiences of OC patients.

RESULTS

Three themes with various sub-themes were identified as follow: a)lack of cancer diagnostic suspicion (lack of knowledge of symptoms of OC, anamnesis and physical examination overlooked, fragmentation of patient's care and bias and prejudice); b)difficulties in activating the diagnostic process (limited access to tests, unequal accessibility to gynaecology and lack of follow-up); and c)absence of fast-track referral system.

CONCLUSIONS

The results offer insight into the difficulties of early diagnosis of OC in our setting. We believe that their identification will allow the development of strategies to improve diagnostic accuracy and quality of care for women with OC in our setting.

摘要

目的

通过分析卫生专业人员对卵巢癌(OC)患者病例经历的看法,确定加泰罗尼亚公共卫生系统中卵巢癌诊断方面存在的错失机会。

设计

定性探索性描述性研究,采用两个焦点小组。

地点

初级保健机构,2017年11月。

参与者

基于理论抽样的34名专业人员:21名家庭医生、8名性与生殖健康中心的专业人员和5名医院妇科医生。

方法

参与者通过展示根据三名卵巢癌患者的病例和经历制定的流程图,讨论了卵巢癌女性患者的不同诊断途径。

结果

确定了三个主题及多个子主题,如下所示:a)缺乏癌症诊断怀疑(对卵巢癌症状缺乏了解、病史和体格检查被忽视、患者护理碎片化以及偏见和成见);b)启动诊断过程存在困难(检查机会有限、妇科就诊机会不平等以及缺乏随访);c)缺乏快速转诊系统。

结论

研究结果揭示了我们所在地区卵巢癌早期诊断的困难。我们认为,识别这些困难将有助于制定策略,提高我们所在地区卵巢癌女性患者的诊断准确性和护理质量。