title: Patients' confidence in their GP before and after being diagnosed with cancer.
abstract: BACKGROUND
  General practice plays an important role in the cancer care pathway. The initial diagnostic phase may be crucial for the relationship between the patient and the GP.
  
  
  OBJECTIVE
  The aim was to describe whether patients' confidence in their GP changed after a cancer diagnosis, and analyse whether the change in confidence was associated with doctor delay.
  
  
  METHODS
  Population-based cohort study with 1892 questionnaires sent to patients and their GPs in general practices in the former Aarhus County, Denmark.
  
  
  METHODS
  Information on patients' confidence in their GP was obtained from the patient questionnaire. Information on doctor delay was obtained from the GPs and defined as a period of 14 days or more from the date of first symptom presentation to the GP until cancer-specific investigation was initiated.
  
  
  RESULTS
  Before the cancer diagnosis, 88.4% of the patients had confidence in their GP, which decreased to 80.0% after the diagnosis (P<0.001); 15.8% of the patients who experienced no doctor delay reported a decrease in confidence after the cancer diagnosis, compared with 29.1% of the patients with a doctor delay (P<0.001). Patients presenting with alarm symptoms and experiencing doctor delay were 3.8 times more likely to lose confidence compared with those presenting with alarm symptoms who experienced no doctor delay (P = 0.048).
  
  
  CONCLUSIONS
  The majority of the patients had high levels of confidence in their GP before, as well as after, the cancer diagnosis. Nevertheless, a substantial amount had low confidence in the GP, especially when experiencing doctor delay in the initial phase of the pathway.
authors.affiliation: The Research Unit for General Practice and Section for General Medical Practice, School of Public Health, Aarhus University, Denmark. mette.bach.larsen@alm.au.dk
authors.forename: Mette B
authors.initials: MB
authors.lastname: Larsen
authors.forename: Rikke P
authors.initials: RP
authors.lastname: Hansen
authors.forename: Frede
authors.initials: F
authors.lastname: Olesen
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D058006:General Practice / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011364:Professional Practice / Q000592:standards*; D035502:Trust / Q000523:psychology*; D055815:Young Adult