How can experiences of patients and carers influence the clinical care of large bowel cancer?
A qualitative project was designed to investigate the care of large bowel cancer from patients' and carers' perspectives using semi-structured interviews; tape-recorded, transcribed and analysed; to identify recurrent themes. Forty-nine patients treated surgically for bowel cancer from three hospital trusts in West Surrey were visited at home, and eight of their carers attended a focus group from a choice of three geographical locations. Five main themes identified: experience of symptoms; general practitioner (GP) management; impact of diagnosis; perceptions of clinical care and treatment; information needs. Results showed that patients and carers were ignorant of the symptoms and signs of large bowel cancer and wanted more information. They were satisfied when the GP took symptoms seriously and referred promptly. Three groups of patients were particularly vulnerable: those requiring stomas (25), those diagnosed with polyps initially (11) and patients admitted as an emergency (7). Specialist nurses were seen as the main source of written information and support, which was most needed at the time of diagnosis and discharge. The public needs more accessible information about the symptoms and signs of bowel cancer. Referral to multiprofessional bowel cancer teams is essential to provide appropriate support and clear information from the time of diagnosis throughout the care pathway. Recommended strategies for improving clinical care are outlined.
Broughton
M
M
C/o West Surrey NHS Health Promotion Service, Surrey, UK. cimbroughton@aol.com
Bailey
J
J
Linney
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000458:organization & administration; D030881:Disclosure / Q000592:standards; D004739:England; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D007420:Intestine, Large; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012017:Referral and Consultation