Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways
| العنوان: | Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways |
|---|---|
| المؤلفون: | Gillian E Doe, Marie T Williams, Stacey Chantrell, Michael C Steiner, Natalie Armstrong, Ann Hutchinson, Rachael A Evans |
| المساهمون: | Doe, Gillian E, Williams, Marie T, Chantrell, Stacey, Steiner, Michael C, Armstrong, Natalie, Hutchinson, Ann, Evans, Rachael A |
| المصدر: | British Journal of General Practice. 73:e468-e477 |
| بيانات النشر: | Royal College of General Practitioners, 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | primary care, diagnosis, breathlessness, Family Practice, qualitative research |
| الوصف: | BackgroundEvidence about the delays to diagnosis for patients presenting with breathlessness is lacking.AimTo explore current care of patients with breathlessness through the experiences of adults presenting with chronic breathlessness who are awaiting a diagnosis and the experiences of primary care clinicians.Design and settingQualitative study with adults presenting with chronic breathlessness and clinicians across 10 general practices.MethodSemi-structured interviews were conducted with patients and clinicians. Participants were recruited from a feasibility cluster randomised controlled trial investigating a structured diagnostic pathway for breathlessness. An interview guide explored experiences of help seeking for breathlessness, the diagnostic process, and associated health care. Transcripts were analysed using thematic analysis supported by NVivo software.ResultsInterviews were conducted with 34 patients (mean age 68 years, standard deviation [SD] 10.8, of whom 20 were female [59%]) and 10 clinicians (mean 17 years of experience, SD 6.3, of whom five were female [50%]). Five themes were identified: recognising and validating symptoms of breathlessness is an important first step; clinical decision making for breathlessness is complex; difficult conversations arise when a disease-related diagnosis is not confirmed; disease management rather than symptom management is prioritised by clinicians; and patient experience is influenced by clinician communication style.ConclusionThe findings indicate potential explanations for delays to diagnosis for patients with chronic breathlessness. Interventions are needed to enhance symptom recognition, include alternative approaches to incremental investigation, and expand the concept of diagnosis beyond a disease label to improve communication, with the ultimate aim of earlier diagnosis and management to improve patient outcomes. |
| تدمد: | 1478-5242 0960-1643 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::978b10e77c5c412336e14b2124446895 https://doi.org/10.3399/bjgp.2022.0475 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....978b10e77c5c412336e14b2124446895 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14785242 09601643 |
|---|