بيانات النشر: UmeÃ¥ universitet, Institutionen för omvÃ¥rdnad
Umeå universitet, Allmänmedicin
Umeå universitet, Institutionen för folkhälsa och klinisk medicin
Research Support Unit Metropolitana Sud, University Institute for Primary Health Care Research IDIAPJordi Gol, Catalan Health Institute, Barcelona, Spain
Department of Family Medicine, Riga Stradiņš University, Riga, Latvia
Department of Family Medicine, Medical University of Białystok, Białystok, Poland
Majorca Primary Care Department, Spain; Balearic Islands Health Research Institute (IdISBa), Balearic Islands, Spain
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Center of General Practice,Tampere University Hospital, Tampere, Finland
Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Local Health Authority Committee, Palermo City, Italy
Department of Family Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia; Health Center Zagreb-Centar, Zagreb, Croatia
Department Urology and General Practice, Medical University of Plovdiv, Plovdiv, Bulgaria
Croatian Health Insurance Fund, Rijeka, Croatia
Department of Health and Society, General Practice Research Unit, University of Oslo, Oslo, Norway
Family Medicine Department, Marmara University Medical School, Istanbul, Turkey
Department of General Practice, Maastricht University, Maastricht, The Netherlands
Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Family Medicine, Maccabi Healthcare Services, Southern District, Israel
Department of Family Medicine and Outpatient Care, Medical Faculty #2, Uzhhorod National University, Uzhgorod, Ukraine
Centre of Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
Department of Family Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
Family Medicine Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland; College of Medicine & Health, University of Exeter, Exeter, UK
Royal College of General Practitioners
نبذة مختصرة : Background: While primary care physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. Aim: To explore European PCPs’ experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. Design & setting: A multicentre European qualitative study, based on an online survey with open-ended questions, asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. Method: Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. Results: A total of 158 PCPs completed the questionnaire. The main themes were as follows: patients’ descriptions did not suggest cancer; distracting factors reduced PCPs’ cancer suspicions; patients’ hesitancy delayed the diagnosis; system factors not facilitating timely diagnosis; PCPs felt that they had acted wrongly; and problems with communicating adequately. Conclusion: The study identified six overarching themes that need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The ‘Swiss cheese’ model of accident causation showed how the themes related to each other.
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