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Health Expect ; 18(6): 2192-201, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24661322

RESUMO

OBJECTIVE: To explore patients' preferences for follow-up in primary care vs. secondary care. METHODS: A cross-sectional design was employed, involving semi-structured interviews with 70 female patients with a history of early-stage breast cancer. Using descriptive content analysis, interview transcripts were analysed independently and thematically by two researchers. FINDINGS: Patients expressed the strongest preference for annual visits (31/68), a schedule with a decreasing frequency over time (27/68), and follow-up > 10 years, including lifelong follow-up (20/64). The majority (56/61) preferred to receive follow-up care from the same care provider over time, for reasons related to a personal doctor-patient relationship and the physician's knowledge of the patient's history. About 75% (43/56) preferred specialist follow-up to other follow-up models. However, primary care-based follow-up would be accepted by 57% (39/68) provided that there is good communication between GPs and specialists, and sufficient knowledge among GPs about follow-up. Perceived benefits of primary care-based follow-up referred to the personal nature of the GP-patient relationship and the easy access to primary care. Perceived barriers included limited oncology knowledge and skills, time available, motivation among GPs to provide follow-up care and patients' confidence with the present specialist follow-up. CONCLUSIONS: More than half of the patients were open to primary care-based follow-up. Patients' confidence with this follow-up model may increase by using survivorship care plans to facilitate communication across the primary/secondary interface and with patients. Training GPs to improve their oncology knowledge and skills might also increase patients' confidence.


Assuntos
Neoplasias da Mama/terapia , Preferência do Paciente , Atenção Primária à Saúde , Atenção Secundária à Saúde/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/psicologia , Continuidade da Assistência ao Paciente , Estudos Transversais , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Oncologia , Pessoa de Meia-Idade , Países Baixos , Relações Médico-Paciente , Pesquisa Qualitativa , Inquéritos e Questionários
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