Delivering the faecal occult blood test: More instructions than shared decisions. A qualitative study among French GPs

Abstract

Background:Colorectal cancer (CRC) is the third most common cancer worldwide. In France, mass screening has been established with FOBT since 2008. The participation rate remains too low. Previous studies were conducted to explore doctors ' and patients ' perspectives. Objective: This study was conducted to explore GPs ' performance during consultations in which patients ask for FOBT, focusing on two diff erent aspects: the core content of the consultation and the communication style used between GPs and patients. Methods: Nine purposively sampled GPs were asked to audiotape specifi c consultations. Content analysis was performed using Nvivo 9 software. Communication between doctors and patients was explored using RIAS coding. Results: GPs audio taped specifi c parts of 35 diff erent consultations when they discussed and delivered the FOBT. The core content included primarily biomedical statements with a large portion dedicated to technical aspects. The communication style was not patient-centred. Conclusion:While the participation rate of mass screening in France is still low, the analysis of recorded consultations by French GPs confi rms that the way of delivering FOBT can be improved.

Efficacy of communication skills training on colorectal cancer screening by GPs: a cluster randomised controlled trial

“…This cRCT is particularly original because the intervention content focused on communication skills between GPs and their patients and was based on qualitative data previously collected from patients and doctors in primary care settings (Aubin‐Auger et al . , ). Patient‐centred care, though recognised as a component of high‐quality health care, is not yet taught at every French medical university.…”

“…To have a better overview of the gFOBT delivery in real life, 35 consultations with 9 GPs in which patients came and asked for gFOBT were audio‐recorded to analyse doctor–patient communication (Aubin‐Auger et al . ). Based on a Roter analysis (Roter ; Roter & Larson ), the data showed that the communication style during these consultations was not patient‐centred.…”

Bringing personal perspective elicitation to the heart of shared decision-making: a scoping review

“…The word 'concerns' is also often used in relation to PPE, studies use this word to describe that patients were disclosing their concerns, or that their concerns were elicited. Besides SDM, which was part of the inclusion criteria, five studies described PPE from a viewpoint of patient-centred care [80,81,94,100,101], four studies mentioned person-centred care [95,109,115,117], and three studies reported concordance as terminology [84,111,120], meaning agreement between patient and clinician.…”

Improvement of participation rate in colorectal cancer (CRC) screening by training general practitioners in motivational interviewing (AmDepCCR)

“…GPs play a central role in CRC screening by offering testing and repeating the individual and societal usefulness of screening for CRC. Thus, in 2015, a French study showed that when the tests were delivered by GPs, they were carried out in 89% of cases [ 20 ]. The main obstacle to the patient’s decision to perform the test was the absence of a proposal by the GP, and communication mainly focused on biomedical data [ 20 ].…”

“…Thus, in 2015, a French study showed that when the tests were delivered by GPs, they were carried out in 89% of cases [ 20 ]. The main obstacle to the patient’s decision to perform the test was the absence of a proposal by the GP, and communication mainly focused on biomedical data [ 20 ]. Several studies have investigated the reasons why GPs do not offer the CRC screening test.…”