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Exploring why European primary care physicians sometimes do not think of, or act on, a possible cancer diagnosis: a qualitative study
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.ORCID-id: 0000-0003-0661-8269
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.ORCID-id: 0000-0001-8846-7681
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.
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2023 (Engelska)Ingår i: BJGP Open, E-ISSN 2398-3795, Vol. 7, nr 4, artikel-id BJGPO.2023.0029Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
Royal College of General Practitioners , 2023. Vol. 7, nr 4, artikel-id BJGPO.2023.0029
Nyckelord [en]
Primary health care, physicians, primary care, cancer, Europe, diagnostic errors, qualitative research
Nationell ämneskategori
Omvårdnad Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:umu:diva-214654DOI: 10.3399/bjgpo.2023.0029PubMedID: 37380218Scopus ID: 2-s2.0-85180193308OAI: oai:DiVA.org:umu-214654DiVA, id: diva2:1799415
Tillgänglig från: 2023-09-22 Skapad: 2023-09-22 Senast uppdaterad: 2024-02-19Bibliografiskt granskad

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Hajdarevic, SenadaHögberg, Cecilia

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Hajdarevic, SenadaHögberg, CeciliaHarris, Michael
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Institutionen för omvårdnadAllmänmedicinInstitutionen för folkhälsa och klinisk medicin
OmvårdnadCancer och onkologi

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