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加拿大安大略省急诊医生对疑似癌症诊断患者的管理经验:一项定性研究。

Emergency physicians' experiences managing patients with a suspected cancer diagnosis in Ontario, Canada: a qualitative study.

作者信息

Moore Carley, Petrovic Bojana, Bender Jacqueline L, Thompson Cameron, McLeod Shelley L, Savage David, Borgundvaag Bjug, Ovens Howard, Irish Jonathan, Eskander Antoine, Cheskes Sheldon, Krzyzanowska Monika, de Wit Kerstin, Mohindra Rohit, Thiruganasambandamoorthy Venkatesh, Grewal Keerat

机构信息

University of Toronto, Toronto, Ontario, Canada.

Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2025 Sep 8;15(9):e096506. doi: 10.1136/bmjopen-2024-096506.

Abstract

OBJECTIVE

The emergency department (ED) often serves as a crucial pathway for cancer diagnosis. However, little is known about the management of patients with new suspected cancer diagnoses in the ED. The objective of this study was to explore emergency physicians' experiences in managing patients with a newly suspected cancer diagnosis in the ED.

DESIGN

Between January and April 2024, we conducted a qualitative descriptive study. Interviews were conducted by trained research personnel using a semistructured interview guide. Interviews were conducted until thematic saturation was achieved. The interview transcripts were coded and thematic analysis was used to uncover key themes.

SETTING AND PARTICIPANTS

Emergency physicians practising in Ontario, Canada.

RESULTS

20 emergency physicians were interviewed. Four themes around the management of patients with new suspected cancer diagnoses in the ED were identified: (1) healthcare system-level factors that impact suspected cancer diagnosis through the ED, (2) institutional and provider-level challenges associated with managing patients with a suspected cancer diagnosis in the ED, (3) patient-level characteristics and experiences of receiving a cancer diagnosis in the ED and (4) the need for care coordination for patients with suspected cancer in the ED.

CONCLUSIONS

Physicians experienced several unique challenges in managing patients with a suspected cancer diagnosis in the ED. Overall, the findings of this study suggest these challenges often make the ED a difficult environment in which to deliver a suspected cancer diagnosis.

摘要

目的

急诊科(ED)常常是癌症诊断的关键途径。然而,对于急诊科中新诊断为疑似癌症患者的管理,我们了解甚少。本研究的目的是探讨急诊医生在急诊科管理新诊断为疑似癌症患者的经验。

设计

在2024年1月至4月期间,我们进行了一项定性描述性研究。由经过培训的研究人员使用半结构化访谈指南进行访谈。访谈持续进行直至达到主题饱和。对访谈记录进行编码,并采用主题分析来揭示关键主题。

背景与参与者

在加拿大安大略省执业的急诊医生。

结果

对20名急诊医生进行了访谈。确定了围绕急诊科中新诊断为疑似癌症患者管理的四个主题:(1)通过急诊科影响疑似癌症诊断的医疗系统层面因素;(2)在急诊科管理疑似癌症诊断患者相关的机构和提供者层面挑战;(3)患者层面在急诊科接受癌症诊断的特征和经历;(4)急诊科中疑似癌症患者的护理协调需求。

结论

医生在急诊科管理疑似癌症诊断患者时遇到了一些独特的挑战。总体而言,本研究结果表明,这些挑战常常使急诊科成为一个难以做出疑似癌症诊断的环境。

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