Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views
Impact of the COVID-19 pandemic on cancer assessment in primary care: a qualitative study of GP views
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DOI：
10.3399/bjgpo.2021.0056
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发表时间：
2021-08-01
期刊：
影响因子：
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通讯作者：
Walter, Fiona M.
中科院分区：
文献类型：
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作者：
Archer, Stephanie;Calanzani, Natalia;Walter, Fiona M.
背景：早期诊断是改善癌症预后的关键，大多数癌症在最初的症状表现后在初级保健中被诊断出来。新出现的证据表明，由于COVID-19大流行，可避免的癌症死亡人数增加。目的：了解全科医生对COVID-19大流行对可能癌症的临床评估的影响的看法。设计与背景：对来自英格兰东部的全科医生进行了一项定性的半结构化访谈研究。方法：根据年龄、性别和经验年限对全科医生进行有目的的抽样。于二零二零年八月及九月透过Zoom或Microsoft Teams进行访谈。转录录音进行了分析归纳使用主题分析。治疗途径模式指导了分析。结果如下：在23次关于全科医生对以下影响的看法的访谈中确定了三个主题：（1）患者在出现症状时寻求帮助行为的变化;（2）管理可能有癌症症状的患者的远程咨询;以及（3）COVID-19大流行对可能患有癌症的患者的分流和转介。做法上有了积极的变化，但有人对远程咨询是否足以评估症状表示关切。一些全科医生报告了癌症诊断的延迟，以及如何管理转诊积压的不确定性。结论：这项研究提供了新的证据，说明COVID-19大流行对现在和未来评估适当症状评估的影响。
Background: Early diagnosis is key to improve cancer outcomes, and most cancers are diagnosed in primary care after initial symptomatic presentation. Emerging evidence suggests an increase in avoidable cancer deaths owing to the COVID-19 pandemic. Aim: To understand GPs' views on the impact of the COVID-19 pandemic on the clinical assessment of possible cancer. Design & setting: A qualitative semi- structured interview study with GPs from the East of England. Method: GPs were purposively sampled based on age, sex, and years of experience. Interviews were conducted via Zoom or Microsoft Teams in August and September 2020. Transcribed recordings were analysed inductively using thematic analysis. The Model of Pathways to Treatment guided the analysis. Results: Three themes were identified across 23 interviews on GP views on the impact of: (1) changes in patient help- seeking behaviour on symptoms at presentation; (2) remote consultations on managing patients with possible cancer symptoms; and (3) the COVID-19 pandemic on triaging and referring patients with possible cancer. There were positive changes to practice, but concerns were raised about the adequacy of remote consultations for assessing symptoms. Some GPs reported delayed cancer diagnoses, and uncertainty about how backlog in referrals would be managed. Conclusion: This study provides new evidence on the impact of the COVID-19 pandemic on assessing appropriate symptomatic assessment now and in the future.