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Oncologists perceived barriers to an expanded role for primary care in breast cancer survivorship care

机译:肿瘤学家认为扩大乳腺癌生存幸存护理中的初级护理作用的障碍

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摘要

Concern exists about the sustainability of traditional, oncologist‐led models of breast cancer survivorship care. However, many oncologists are hesitant about deferring survivorship care to primary care providers (PCPs). Our objective was to examine oncologists' perceptions of the role PCPs play in breast cancer survivorship and the rationale underlying these perceptions. One‐on‐one interviews with medical, radiation, and surgical oncologists in Wisconsin were conducted (n = 35) and transcribed. Data analysis was performed using an inductive approach to content analysis. Oncologist‐perceived barriers included: PCP's level of experience with cancer care; Lack of PCP comfort in providing survivorship care; Existing demands on PCPs' time; Patient preference for oncology‐led survivorship care. Oncologists described familiarity and trust in individual PCPs as factors that could mitigate barriers and lead to increased PCP involvement in survivorship care. Although a number of perceived barriers to PCP participation in survivorship were identified by Wisconsin oncologists, our findings support the direction of ongoing initiatives to facilitate PCP involvement. Our findings also suggest that early PCP involvement in survivorship may increase PCP comfort and patients' trust in PCPs in this role. The identified barrier most challenging to address may be the limited capacity of the current primary care system to manage follow‐up for breast cancer survivors.
机译:对传统的由肿瘤学家主导的乳腺癌幸存护理模型的可持续性存在担忧。但是,许多肿瘤学家对于将生存期医疗服务推迟到初级保健提供者(PCP)犹豫不决。我们的目标是检查肿瘤科医生对五氯苯酚在乳腺癌幸存者中发挥作用的看法以及这些看法的基本原理。对威斯康星州的内科,放射科和外科肿瘤学家进行了一对一访谈(n = 35)并进行了转录。数据分析使用归纳法进行内容分析。肿瘤学家认为的障碍包括:PCP在癌症护理方面的经验水平; PCP在提供生存护理方面缺乏安慰;对PCP时间的现有要求;患者偏爱肿瘤科主导的生存治疗。肿瘤学家将对个体PCP的熟悉和信任描述为可以减轻障碍并导致PCP越来越多地参与生存护理的因素。尽管威斯康星州的肿瘤科医生发现了PCP参与生存的许多障碍,但我们的发现支持了旨在促进PCP参与的现行计划的方向。我们的研究结果还表明,早期PCP参与生存可能会增加PCP的舒适度和患者对此角色的信任。所面临的最具挑战性的障碍可能是当前的初级保健系统管理乳腺癌幸存者随访的能力有限。

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