title: Collaboration and communication in colorectal cancer care: a qualitative study of the challenges experienced by patients and health care professionals.
abstract: BACKGROUND
  Colorectal cancer is becoming a chronic condition. This has significant implications for the delivery of health care and implies the involvement of a range of health care professionals (HCPs) from different settings to ensure the needed quality and continuity of care.
  
  
  OBJECTIVE
  To explore the challenges that patients and HCPs experience in the course of colorectal cancer care and the perceived consequences caused by these challenges.
  
  
  METHODS
  Ten semi-structured focus groups were conducted including patients receiving treatment for colorectal cancer, representatives of patient support groups, physicians and other non-physician HCPs from different health care settings. Participants were asked to share their experiences regarding colorectal cancer care. All data were audio- and videotaped, transcribed verbatim and thematically analysed using qualitative content analysis.
  
  
  RESULTS
  Patients and HCPs (total N = 47) experienced collaboration and communication as well as exchange of information between HCPs as challenging. Particularly communication and information exchange with GPs appeared to be lacking. The difficulties identified restricted a well-working coordination of care and seemed to cause inappropriate health care.
  
  
  CONCLUSIONS
  Colorectal cancer care seems to require an effective, well-working collaboration and communication between the different HCPs involved ensuring the best possible care to suit patients' individual needs. However, the perceived challenges and consequences of our participants seem to restrict the delivery of the needed quality of care. Therefore, it seems crucial (i) to include all HCPs involved, especially the GP, (ii) to support an efficient and standardized exchange of health-related information and (iii) to focus on the patients' entire pathway of care.
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and martina.kamradt@med.uni-heidelberg.de.
authors: Martina
authors: M
authors: Kamradt
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and.
authors: Ines
authors: I
authors: Baudendistel
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and.
authors: Gerda
authors: G
authors: Längst
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and.
authors: Marion
authors: M
authors: Kiel
authors: Ethics and Patient-Oriented Care, National Centre for Tumor Diseases Heidelberg, Heidelberg, Germany.
authors: Felicitas
authors: F
authors: Eckrich
authors: Ethics and Patient-Oriented Care, National Centre for Tumor Diseases Heidelberg, Heidelberg, Germany.
authors: Eva
authors: E
authors: Winkler
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and.
authors: Joachim
authors: J
authors: Szecsenyi
authors: Department of General Practice and Health Services Research, University Hospital Heidelberg and.
authors: Dominik
authors: D
authors: Ose
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000628:therapy*; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012657:Self-Help Groups
keywords: Collaboration; colorectal cancer; communication; general practitioner; qualitative methods; quality of health care.