Factors influencing the referrals in primary care of asymptomatic patients with a family history of cancer
| Autor: | Jenny Hewison, Hamdan Al-Habsi, Carol E Chu, Jennifer N W Lim |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Health Knowledge Attitudes Practice medicine.medical_specialty Referral Attitude of Health Personnel Genetic counseling MEDLINE Genetic Counseling Context (language use) Anxiety Asymptomatic Neoplasms Surveys and Questionnaires medicine Humans Genetic Testing Family history Physician's Role Referral and Consultation Index case Genetics (clinical) Genetic testing Primary Health Care medicine.diagnostic_test business.industry Physicians Family Middle Aged United Kingdom Family medicine Female medicine.symptom business |
| Zdroj: | Genetics in Medicine. 10:751-757 |
| ISSN: | 1098-3600 |
| DOI: | 10.1097/gim.0b013e318185212a |
| Popis: | Purpose: To describe the events and the reasoning that led UK general practitioners to make a direct referral to a genetics clinic for a family history of cancer. Methods: Asymptomatic patients with a family history of cancer and general practitioners who had referred them to a genetics clinic were eligible to participate. Semi-structured interviews incorporating a self-completed questionnaire were conducted with the general practitioners. Questions about the referral had to be framed in general terms as few general practitioners could remember the index case. Individual face-to-face interviews based on a topic guide were conducted with the patients. Results: Thirty-six of 54 eligible general practitioners and 71 asymptomatic patients with a family history of cancer completed the study. General practitioners adopted a reactive rather than proactive role in the provision of genetic services for asymptomatic patients with a family history of cancer. Most general practitioners favored cancer diagnostic clinics as a referral pathway, and made a referral to genetics only when patients or a hospital doctor specifically requested this. More idiosyncratic approaches to the referral decision were also encountered. Updating of skills and knowledge in genetics remained a low priority despite acknowledged inadequacies. Conclusions: Referral guidelines that are practicable in the context of a busy primary care clinic need to be developed if primary care practitioners are to play the major role desired for them in genetics. |
| Databáze: | OpenAIRE |
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