What factors empower general practitioners for early cancer diagnosis? A 20-country European Delphi Study.
Delphi method
Primary Health Care
cancer
empowerment
general practitioners
Journal
Primary health care research & development
ISSN: 1477-1128
Titre abrégé: Prim Health Care Res Dev
Pays: England
ID NLM: 100897390
Informations de publication
Date de publication:
25 11 2022
25 11 2022
Historique:
entrez:
25
11
2022
pubmed:
26
11
2022
medline:
29
11
2022
Statut:
epublish
Résumé
Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses. To identify the factors that affect European GPs' empowerment in making an early diagnosis of cancer. This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale.The final list of statements indicated those that were considered by consensus to be the most relevant. In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs' working conditions. Statements relating to training, skills and working efficiency were not considered priority areas. GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis.
Sections du résumé
BACKGROUND
Some symptoms are recognised as red flags for cancer, causing the General Practitioner (GP) to refer the patient for investigation without delay. However, many early symptoms of cancer are vague and unspecific, and in these cases, a delay in referral risks a diagnosis of cancer that is too late. Empowering GPs in their management of patients that may have cancer is likely to lead to more timely cancer diagnoses.
AIM
To identify the factors that affect European GPs' empowerment in making an early diagnosis of cancer.
METHODS
This was a Delphi study involving GPs in 20 European countries. We presented GPs with 52 statements representing factors that could empower GPs to increase the number of early cancer diagnoses. Over three Delphi rounds, we asked GPs to indicate the clinical relevance of each statement on a Likert scale.The final list of statements indicated those that were considered by consensus to be the most relevant.
RESULTS
In total, 53 GPs from 20 European countries completed the Delphi process, out of the 68 GPs who completed round one. Twelve statements satisfied the pre-defined criteria for relevance. Five of the statements related to screening and four to the primary/secondary care interface. The other selected statements concerned information technology (IT) and GPs' working conditions. Statements relating to training, skills and working efficiency were not considered priority areas.
CONCLUSION
GPs consider that system factors relating to screening, the primary-secondary care interface, IT and their working conditions are key to enhancing their empowerment in patients that could have cancer. These findings provide the basis for seeking actions and policies that will support GPs in their efforts to achieve timely cancer diagnosis.
Identifiants
pubmed: 36426593
pii: S1463423622000652
doi: 10.1017/S1463423622000652
pmc: PMC9706379
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e76Références
Health Policy. 2012 Apr;105(1):65-70
pubmed: 22136810
J Health Polit Policy Law. 2004 Dec;29(6):1045-71
pubmed: 15688577
Nurs Health Sci. 2019 Mar;21(1):54-62
pubmed: 30091283
J Med Internet Res. 2019 Mar 26;21(3):e12490
pubmed: 30912758
BMC Health Serv Res. 2018 May 8;18(1):338
pubmed: 29739409
Lancet Oncol. 2009 Jul;10(7):693-9
pubmed: 19573798
Hered Cancer Clin Pract. 2013 Oct 28;11(1):16
pubmed: 24165150
J Occup Environ Med. 2020 Jul;62(7):478-483
pubmed: 32730023
Hum Resour Health. 2020 Oct 16;18(1):76
pubmed: 33066776
Future Hosp J. 2016 Jun;3(2):90-93
pubmed: 31098194
Eur J Cancer Prev. 1993 May;2(3):229-32
pubmed: 8490541
Fam Pract. 2020 Feb 19;37(1):63-68
pubmed: 31372649
BMJ. 2016 Nov 9;355:i5515
pubmed: 28291732
Cancer. 2020 Apr 1;126(7):1374-1375
pubmed: 32163607
J Nurs Educ. 2004 Mar;43(3):107-15
pubmed: 15072337
BMJ Open. 2020 Oct 31;10(10):e035678
pubmed: 33130560
Eur J Cancer. 2017 Nov;85:1-5
pubmed: 28881246
J Nurs Meas. 1999 Spring;7(1):79-96
pubmed: 10394776
PLoS One. 2011;6(6):e20476
pubmed: 21694759
Nurs Econ. 1998 Sep-Oct;16(5):254-7, 253
pubmed: 9987323
Evid Based Nurs. 2020 Jul;23(3):68-69
pubmed: 32430290
Scand J Prim Health Care. 2015 Jun;33(2):134-41
pubmed: 26100966
Semin Oncol Nurs. 2017 May;33(2):121-128
pubmed: 28343835
WMJ. 2007 Dec;106(8):458-9
pubmed: 18237068
J Adv Nurs. 2013 Apr;69(4):947-59
pubmed: 22764828
Br J Gen Pract. 2009 Jun;59(563):441-5, 447; discussion 446
pubmed: 19520027
BMJ Open. 2020 Sep 24;10(9):e038466
pubmed: 32973063