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Views of cancer care reviews in primary care: a qualitative study.

机译:初级保健中癌症护理评论的观点:定性研究。

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摘要

BACKGROUND: The Quality and Outcomes Framework (QOF) provides an incentive for practices to establish a cancer register and conduct a review with cancer patients within 6 months of diagnosis, but implementation is unknown. AIM: To describe: (1) implementation of the QOF cancer care review; (2) patients' experiences of primary care over the first 3 years following a cancer diagnosis; (3) patients' views on optimal care; and (4) the views of primary care professionals regarding their cancer care. DESIGN OF STUDY: Qualitative study using thematic analysis and a framework approach. SETTING: Six general practices in the Thames Valley area. METHOD: Semi-structured interviews with cancer patients and focus groups with primary care teams. RESULTS: Thirty-eight adults with 12 different cancer types were interviewed. Seventy-one primary care team members took part in focus groups. Most cancer care reviews are conducted opportunistically. Thirty-five patients had had a review; only two could recall this. Patients saw acknowledgement of their diagnosis and provision of general support as important and not always adequately provided. An active approach and specific review appointment would legitimise the raising of concerns. Primary care teams considered cancer care to be part of their role. GPs emphasised the importance of being able to respond to individual patients' needs and closer links with secondary care to facilitate a more involved role. CONCLUSION: Patients and primary care teams believe primary care has an important role to play in cancer care. Cancer care reviews in their current format are not helpful, with considerable scope for improving practice in this area. An invitation to attend a specific appointment at the end of active treatment may aid transition from secondary care and improve satisfaction with follow-up in primary care.
机译:背景:质量和结果框架(QOF)为建立癌症登记簿并在诊断后6个月内对癌症患者进行检查的做法提供了动力,但实施方式尚不清楚。目的:描述:(1)QOF癌症护理审查的实施; (2)患者在诊断出癌症后的最初三年中的初级保健经历; (3)患者对最佳护理的看法; (4)初级保健专业人员对其癌症护理的看法。研究设计:使用主题分析和框架方法进行定性研究。地点:泰晤士河谷地区的六种常规做法。方法:对癌症患者和基层医疗团队的焦点小组进行半结构式访谈。结果:38名患有12种不同癌症类型的成年人接受了采访。七十一名初级保健团队成员参加了焦点小组。大多数癌症护理评论都是机会性的。 35例患者进行了回顾性检查。只有两个人可以记得这一点。患者认为对他们的诊断的认可和提供一般支持是重要的,而且并不总是能提供足够的。积极的做法和专门的审查任命将使引起关注的问题合法化。初级保健团队认为癌症护理是其职责的一部分。全科医生强调了必须能够满足患者的需求,并与二级保健机构建立更紧密的联系,以促进更多参与性工作的重要性。结论:患者和初级保健团队认为初级保健在癌症护理中起着重要作用。以当前格式进行的癌症护理评论无济于事,在很大程度上可以改善该领域的实践。在积极治疗结束时邀请患者参加特定的约会可能有助于从二级治疗过渡,并提高对初级保健随访的满意度。

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