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Patient, Provider and System Factors Impacting on the Diagnosis and Management of Lung Cancer Care in Australia

Journal of Cancer Therapy 2012年第4期3卷 406-411页

作者： moyez jiwa Patricia M. Davidson Phillip J. Newton Michelle L. Digiacomo Sarah J. McGrath Cornelius J. Lotriet Centre for Cardiovascular and Chronic Care Faculty of Health University of Technology Sydney Sydney Australia Curtin Health Innovation Research Institute Curtin University Perth Australia

Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with particular reference to Australian primary care. Methods: A sequential mixed method modified approach employing interview and a two-phased survey technique. Following telephonic interviews with 31 health professionals (individuals representing general practitioners, specialized physicians, nurses and allied health practitioners), interview data was analysed using qualitative thematic analysis, and surveys using descriptive statistics. Emergent themes were organised under patient, provider and system factors. Interviews ceased upon saturation of data. Results: Multiple patient, provider and systems issues were seen to contribute to adverse health outcomes. There is a strong relationship between smoking and outcomes, and factors related to higher smoking rates such as a lower socioeconomic status. For smokers, guilt and/or denial was considered a reason for delay in the decision to seek medical care for cough or shortness of breath. Aboriginal people under-report morbidity related to smoking and chronic obstructive pulmonary disease;other patients fail to recognise the significance of their symptoms. Discussion: Despite the poor prognosis of lung cancer diagnosis, increased awareness of presentation and treatment options can address disparities in health outcomes.

关键词： Lung Cancer Primary Care General Practice Survival Diagnosis

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