It is important that the process goes quickly, isn't it?” A qualitative multi-country study of colorectal or lung cancer patients' narratives of the timeliness of diagnosis and quality of care

Malmström, Marlene; Rasmussén, Birgit H.; Bernhardson, Britt-Marie; Hajdarević, Senada; Andersen, Rikke Sand; MacArtney, John I.

doi:10.1016/j.ejon.2018.04.002

Cited by 16 publications

(15 citation statements)

References 47 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Timely care also adds to patients’ quality of life and emotional well-being 24. In addition, patients’ descriptions of the quality of their care are closely related to the speed of their diagnosis and treatment; this is because they are concerned that longer waits might allow time for their cancers to grow 25…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis

et al. 2019

View full text Add to dashboard Cite

BackgroundNational European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis.ObjectivesThis study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved.DesignIn an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data.SettingA primary care study, with participating centres in 20 European countries.ParticipantsA total of 1352 PCPs answered the final survey question, with a median of 48 per country.ResultsThe main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these.ConclusionsTo achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Timely diagnosis of cancer has therefore been an important aim of healthcare providers across Europe 25. However, the challenge in deciding where and how to achieve this is substantial 26.…”

Section: Introductionmentioning

confidence: 99%

How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Participants saw the FDS as a way of clarifying when they could rightfully phone to chase test results, but the majority felt 28 days was too long to wait for suspected cancer, and they would contact providers sooner than this. Previous qualitative studies have shown that patients who went on to have a cancer diagnosis considered a 2-week wait to be too long, provoking anxiety 23 , 33. Awareness of current standards for diagnostic referral for cancer was low within the group, with both over- and underestimates of waiting timeframes reported by participants within discussions.…”

Section: Discussionmentioning

confidence: 88%

Exploring public attitudes towards the new Faster Diagnosis Standard for cancer: a focus group study with the UK public

et al. 2019

View full text Add to dashboard Cite

BackgroundThe Faster Diagnosis Standard (FDS) is to be introduced in England in 2020. This standard is a new policy in which patients should have cancer ruled out or diagnosed within 28 days of referral.AimTo explore public attitudes towards the FDS within the context of their recent referral experiences.Design and settingFour 90-minute focus groups (two in Guildford, two in Bradford).MethodParticipants aged >50 years without a current cancer diagnosis (N = 29), who had completed certain diagnostic tests, for example, ultrasound, and received results within the last 6 months were recruited. Age, education, and sex were evenly distributed across groups through purposive sampling.ResultsThe largest cause of concern was the waiting process for obtaining test results. Most had experienced swift referral, and it was difficult for participants to understand how the new standard could impact upon time progressing through the system. Responsibility for meeting the standard was also a concern: participants did not see their own behaviours as a form of involvement. The GP’s role was conceptualised by patients as communicating about their referral, establishing patients’ preferences for information, and continued involvement at each stage of the referral process. The standard legitimised chasing for test results, but 28 days was considered too long.ConclusionPatients should be asked what they would like to know about their referral. GPs should be more transparent about the referral process and the potential for a lack of clarity around next steps.

show abstract

“…, Malmström et al . , Ziebland et al . ) that drew on cross country comparisons to highlight opportunities for service improvement, this article provides a sociological analysis of care, choice and medical authority in patients’ stories of their cancer diagnosis to further our understanding of the changing patient–doctor relationship.…”

Section: Introductionmentioning

confidence: 99%

The convivial and the pastoral in patient–doctor relationships: a multi‐country study of patient stories of care, choice and medical authority in cancer diagnostic processes

MacArtney

Andersen

Malmström

et al. 2020

Sociology Health & Illness

Self Cite

View full text Add to dashboard Cite

Experiences of cancer diagnosis are changing in light of both the increasingly technological-clinical diagnostic processes and the socio-political context in which interpersonal relations take place. This has raised questions about how we might understand patient-doctor relationship marked by asymmetries of knowledge and social capital, but that emphasise patients' empowered choices and individualised care. As part of an interview study of 155 participants with bowel or lung cancer across Denmark, England and Sweden, we explored participants' stories of the decisions made during their cancer diagnostic process. By focusing on the intersections of care, choice and medical authoritya convivial pastoral dynamic we provide a conceptual analysis of the normative ambivalences in people's stories of their cancer diagnosis. We found that participants drew from care, choice and medical authority to emphasise their relationality and interdependence with their doctors in their stories of their diagnosis. Importantly negotiations of an asymmetrical patient-doctor relationship were part of an on-going realisation of the healthcare processes as a human endeavour. We were therefore able to draw attention to the limitations of dichotomising emancipatory-empowerment discourses and argue for a theorisation of the patient-doctor relationship as a contextually bounded and relationally ambivalent humanity. Notes1 The authors recognise the potential rupture of using conviviality outside of the studies of race and racism studies and considered developing alternative conceptualisations. However, it was felt this would be both academically inappropriate and an injustice to the inspiration and work of those cited as well as the wider field of cultural studies from which it was drawn.

show abstract

It is important that the process goes quickly, isn't it?” A qualitative multi-country study of colorectal or lung cancer patients' narratives of the timeliness of diagnosis and quality of care

Cited by 16 publications

References 47 publications

How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis

How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis

Exploring public attitudes towards the new Faster Diagnosis Standard for cancer: a focus group study with the UK public

The convivial and the pastoral in patient–doctor relationships: a multi‐country study of patient stories of care, choice and medical authority in cancer diagnostic processes

Contact Info

Product

Resources

About