Département de Médecine Générale, Faculté de Médecine, Université Paris-Est Créteil (UPEC), Créteil, France.
Pôle PluriProfessionnel de Santé de Coulommiers, Coulommiers, France.
Eur J Gen Pract. 2024 Dec;30(1):2380722. doi: 10.1080/13814788.2024.2380722. Epub 2024 Jul 29.
Health policymakers have tried to improve the care pathway for cancer patients by improving collaboration between participating healthcare professionals by involving the general practitioner (GP).
OBJECTIVE(S): To explore how patients, GPs, oncologists and nurses interacted and how they perceived, in their practice, professional roles, collaboration, and cancer care pathways.
Between January 2018 and December 2021, we conducted a qualitative study that combined phenomenology and a general inductive analysis, based on semi-structured interviews with cancer patients and their GPs, oncologists, and nurses in France.
Our analysis of 59 interviews showed that the stakeholders had different perceptions of the cancer care pathway. Task division was implicit and depended on what each health professional thought he/she should be doing; this led to the blurring of certain tasks (announcement of the diagnosis, coordination, and follow-up). The healthcare professionals were stuck in frameworks centred on their own needs and expectations and were unaware of the other health professionals' needs and expectations. Outside the hospital, GPs and nurses worked in isolation; they were not aware of the other stakeholders and did not communicate with them. GPs and nurses justified this attitude by the lack of a perceived need. Interprofessional communication varied as a function of the needs, involvement and knowledge of the other health professionals and was often mediated by the patient.
In the cancer management in France, to improve cancer care pathway, there is a need to train healthcare professionals in interprofessional collaboration delivering care tailored to patient needs and preferences.
卫生政策制定者试图通过让全科医生参与来改善参与医疗保健专业人员之间的协作,从而改善癌症患者的护理途径。
探索患者、全科医生、肿瘤学家和护士如何互动,以及他们如何在实践中感知专业角色、协作和癌症护理途径。
在 2018 年 1 月至 2021 年 12 月期间,我们进行了一项定性研究,该研究结合了现象学和一般归纳分析,对法国的癌症患者及其全科医生、肿瘤学家和护士进行了半结构化访谈。
我们对 59 次访谈的分析表明,利益相关者对癌症护理途径有不同的看法。任务分工是隐含的,取决于每个卫生专业人员认为自己应该做什么;这导致了某些任务的模糊(诊断通知、协调和随访)。医疗保健专业人员陷入以自身需求和期望为中心的框架中,而没有意识到其他卫生专业人员的需求和期望。在医院外,全科医生和护士孤立地工作;他们不了解其他利益相关者,也不与他们沟通。全科医生和护士以缺乏感知到的需求为理由为这种态度辩护。跨专业沟通因其他卫生专业人员的需求、参与度和知识而异,并且经常由患者介导。
在法国的癌症管理中,为了改善癌症护理途径,需要培训医疗保健专业人员进行跨专业合作,提供符合患者需求和偏好的护理。