The Quality of Care in Oncologic Patients from the Perspective of German General Practitioners - a cross-sectional survey
Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Introduction: While oncologic patients require interdisciplinary care, general practitioners (GPs) are often the first point of contact as well as coordinator of further care proceedings. Although GPs play multiple roles, there is limited research on the status quo general practition-ers’ challenges and needs when caring for oncologic patients in Germany. The objective of this thesis was to explore GPs’ perceptions and experiences in the management of oncological patients. In a further step, an explorative approach was used to check for potential associa-tions. Consequently, this research seeks to address the concerns and potential resolutions identified by GPs in the realm of oncological care. Methods: A 24-item, web-based questionnaire was distributed via emails to German GPs. This cross-sectional study covered demographic information and qualifications, GPs' experiences and views, including perceived patient expectations, and knowledge of patients' symptoms and involvement in decision-making. An additional section asked specifically about radiotherapy follow-up care and the SAPV network, as well as communication practices with other special-ists and GPs’ main roles in oncology care. The survey was open from July 4th to August 9th, 2023. Analyses were carried out descriptively. Chi-square was applied to check for associa-tions between additional qualifications and a) GPs’ knowledge on symptoms, b) GPs’ knowledge on needs, and c) the number of years clinically working. Results: The survey represents the opinions and experiences of 606 GPs with most common-ly either having an additional qualification in palliative care (25.2%) or none at all (22.1%), and representing people having their own office (46.5%). GPs consider their patients’ expectations regarding GP care to be the following: psycho-oncologic support (74.4%), and treating the pa-tient oneself (67.7%). 54.6% reported a 4 out of 5 point Likert scale and 53.8% reported the same scale on how confident they feel in knowing the patients’ symptoms and needs, respec-tively. The supply (48.8%) and the communication (39.3%) with SAPV networks seem to work very well. While 72.3% are content with their degree of involvement in palliative care, only 50.8% reported a barrier-free communication with the oncologist and only 41.7% experienced a sufficient information about follow up care. However, GPs stated to be only moderately (45.6%) to a little (26.1%) involved into radio-therapeutic care plans. Only 4.3% felt very confi-dent in how to handle radio-therapeutic side effects. Further, direct one-on-one medical inter-action is perceived to be the main tasks for GPs (45.6%). Key challenges compromised poor communication and underestimation of GPs role. Proposed solutions included implementation of e-medical reports and further training. Besides, having no additional qualifications seems to influence how knowledgeable GPs are in terms of patients’ symptoms (X2 = 13.30, p=0.01). Specifically, medical tumor therapy and palliative medicine show associations with both symp-toms and needs, while psychotherapy and naturopathic therapy seem to not have an associa-tion on either of both. However, no associations were found between any of the investigated additional qualifications and the number of years clinically working. Conclusion: The enduring bond between a GP and their patient is irreplaceable, underpinning the need for mutual recognition and ongoing education to understand each other's needs. GPs' diverse roles and willingness for greater integration in oncology care can lay the groundwork for a network that alleviates specialists’ workload and communication, thereby potentially im-proving care quality and safety.
Authors: Leiß, Sophia, Technische Universität München
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7042862680