Patients' needs following colorectal cancer diagnosis: where does primary care fit in?
Browne S., Dowie A., Mitchell E., Wyke S., Ziebland S., Campbell N., Macleod U.
BACKGROUND: Colorectal cancer is the third most common cancer in the UK. Patients with colorectal cancer spend most of their time in the community, but the role of primary care in their management and follow-up is unclear. AIM: To explore colorectal cancer patients' experiences of psychosocial problems and their management in primary and specialist care. DESIGN AND SETTING: Longitudinal qualitative study of participants recruited from three hospitals in the west of Scotland and interviewed in their own homes. METHOD: In-depth interviews with 24 participants with a new diagnosis of colorectal cancer, and then follow-up interviews 12 months later. RESULTS: Participants' needs following a diagnosis for colorectal cancer included physical, psychological, and social issues. GPs played a key role in diagnosis, after which they were less involved. Participants valued GPs making unsolicited contact and offering support. Participants described being well supported by clinical nurse specialists who are expert in the illness, and who provide continuity of care and psychological support. A year after diagnosis, when there was less contact with GPs and clinical nurse specialists, participants still faced challenges associated with the ongoing impact of colorectal cancer. CONCLUSION: While some patients enjoyed straightforward recoveries from surgery, others experienced longer-term implications from their disease and treatment, particularly bowel-function issues, fatigue, anxiety, and sexual problems. The potential for primary care to contribute more to the ongoing care of colorectal cancer patients was identified.