Original Article
General practitioners' ‘lived experience’ of assessing psychological distress in cancer patients: an exploratory qualitative study
C.M. Carolan MB ChB, MRCP, MRCGP, MSc,
K. Campbell BSc (Hons), RGN, MN, PG Cert TLHE and BOE,
Corresponding Author
C.M. Carolan MB ChB, MRCP, MRCGP, MSc
Clinical Academic Fellow, GP Locum and GP Appraiser
School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK
NHS Western Isles, Stornoway, UK
Correspondence address: Clare M. Carolan, School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK (e-mail: [email protected]).Search for more papers by this authorK. Campbell BSc (Hons), RGN, MN, PG Cert TLHE and BOE
Macmillan Senior Lecturer/Senior Teaching Fellow
School of Nursing, Midwifery & Social Care, Edinburgh Napier University, Edinburgh, UK
Search for more papers by this authorC.M. Carolan MB ChB, MRCP, MRCGP, MSc,
K. Campbell BSc (Hons), RGN, MN, PG Cert TLHE and BOE,
Corresponding Author
C.M. Carolan MB ChB, MRCP, MRCGP, MSc
Clinical Academic Fellow, GP Locum and GP Appraiser
School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK
NHS Western Isles, Stornoway, UK
Correspondence address: Clare M. Carolan, School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK (e-mail: [email protected]).Search for more papers by this authorK. Campbell BSc (Hons), RGN, MN, PG Cert TLHE and BOE
Macmillan Senior Lecturer/Senior Teaching Fellow
School of Nursing, Midwifery & Social Care, Edinburgh Napier University, Edinburgh, UK
Search for more papers by this authorThe findings of this study were presented at the Scottish School of Primary Care Conference, Glasgow, 2012. It has not been published elsewhere and it is not being considered for publication elsewhere.
Abstract
While psychological distress in cancer patients is common, little is known about how general practitioners (GPs) assess distress. Using semi-structured interviews, a phenomenological study of seven GPs was conducted to explore GPs' experiences of assessing distress. Findings revealed five themes: (1) Being in the Relay Team – receiving and passing the baton: where the assessment of distress was conceptualised as a relay baton passed between a team of health care professionals, with GPs most involved at diagnosis and in the palliative phase. (2) Being in a Relationship: where the doctor–patient relationship was described as a powerful facilitator to assessment. (3) Being Skilled: where GPs perceive they are skilled at assessment adopting a patient-centred approach. (4) Being Challenged – encountering barriers: challenges with assessment were identified regarding the GPs' own emotions, patient related factors and time; the duality of family as both barrier and facilitator was voiced. (5) The Intruder in the Room: where GPs did not use validated screening tools which were viewed as an intruder in the doctor–patient relationship. Further research to objectively assess GPs' skills in distress assessment and attitudes towards the use of screening tools within the cancer care context are merited.
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