家庭医生与肿瘤学家之间的沟通:一项探索性研究的定性结果。

M Dworkind, A Towers, D Murnaghan, R Guibert, D Iverson
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引用次数: 0

摘要

目的:研究家庭医生与肿瘤学家之间的沟通,并探讨可能影响家庭医生参与癌症治疗的因素。设计:本调查设计采用定性方法,其中数据分析使用改进的扎根理论方法。背景:这是一项涉及14个FPs焦点小组的多地点研究,随后对加拿大6个不同省份的116名FPs进行结构化电话采访。主要结果测量:采用访谈问题来探讨FPs在癌症护理中的实际和期望作用,以及FPs在实践中与肿瘤学家就特定癌症患者进行沟通的质量。结果:提供癌症护理的医生必须考虑复杂的社会心理和生物医学因素,比其他慢性疾病更重要,因此仅书面沟通是不够的。家庭医生需要与肿瘤学家面对面和/或电话沟通,以协商他们各自的角色,并讨论患者的预后和拟议治疗的有效性。家庭医生表示希望更多地参与到癌症治疗的各个阶段,包括生物医学和社会心理方面,并帮助更好地确定他们在整个疾病轨迹中的角色。结论:这些结果表明,在不同的临床环境中,家庭医生和肿瘤医生提供的共享癌症护理的沟通、协调和全面程度有待提高。
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Communication between family physicians and oncologists: qualitative results of an exploratory study.

Objective: To study communication between family physicians (FPs) and oncologists, and to look at the factors that may influence FP involvement in cancer care.

Design: This survey design uses a qualitative methodology, where the data are analyzed using a modified grounded theory approach.

Setting: This was a multisite study using 14 focus groups of FPs, followed by structured telephone interviews with 116 FPs in 6 different Canadian provinces.

Main outcome measure: Interview questions were used to explore the actual and desired roles of FPs in cancer care, and the quality of communication with oncologists with reference to a particular cancer patient in the FPs' practice.

Results: Physicians providing cancer care must consider complex psychosocial and biomedical factors, more so than with other chronic diseases, and so written communication alone is inadequate. Family physicians require face-to-face and/or telephone communication with the oncologist to negotiate their respective roles, and to discuss the patient's prognosis and the effectiveness of proposed treatments. Family physicians expressed a desire to become more involved in all stages of cancer care in both the biomedical and psychosocial aspects, and to help better define their roles throughout the illness trajectory.

Conclusion: These results suggest opportunities to improve the communication, coordination and comprehensiveness of shared cancer care provided by family physicians and oncologists in different clinical settings.

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