% 0期刊文章% @ 2561 - 326 x %我JMIR出版物% 卡塔尔世界杯8强波胆分析V 6% N 8% P e39277 % T优化质量改进工具在初级护理癌症诊断:定性研究%A Chima,Sophie %A Martinez-Gutierrez, jaaviera %A Hunter,Barbara %A Manski-Nankervis,Jo-Anne %A Emery,Jon %+癌症研究中心，墨尔本大学维多利亚综合癌症中心，305 Grattan St, Parkville，墨尔本，3010，澳大利亚，61 410 798 352，s.chima@unimelb.edu.au %K癌症%K初级卫生保健%K诊断%K质量改进%K临床决策支持工具%K全科实践%K试点%K可行性%K临床表现反馈干预理论%D 2022 %7 4.8.2022 %9原始论文%J JMIR表格Res %G英文%X背景:癌症诊断最常见的途径是通过初级保健。如果错过了及时诊断的机会，就会出现癌症诊断的延迟，患者在转诊到专家之前多次去看全科医生(GP)就是证明。因此，将延长的诊断间隔时间降至最低并减少对癌症患者进行调查的错失机会的工具是优先考虑的问题。目的:本研究旨在探索一种新型质量改进(QI)工具的有用性和可行性，其中算法标记可能指示未诊断癌症的异常检测结果。这项研究允许在随机对照试验中测试疗效之前优化癌症推荐。方法:招募全科医生、执业护士、执业经理和消费者参加个别访谈或焦点小组。参与者被有意抽样作为试点和可行性研究的一部分，在该研究中，初级保健实践正在接受与前列腺特异性抗原、血小板增多症和缺铁性贫血异常检测结果随访相关的建议。临床表现反馈干预理论(CP-FIT)应用于分析，采用主题方法。 Results: A total of 17 interviews and 3 focus groups (n=18) were completed. Participant themes were mapped to CP-FIT across the constructs of context, recipient, and feedback variables. The key facilitators to use were alignment with workflow, recognized need, the perceived importance of the clinical topic, and the GPs’ perception that the recommendations were within their control. Barriers to use included competing priorities, usability and complexity of the recommendations, and knowledge of the clinical topic. There was consistency between consumer and practitioner perspectives, reporting language concerns associated with the word cancer, the need for more patient-facing resources, and time constraints of the consultation to address patients’ worries. Conclusions: There was a recognized need for the QI tool to support the diagnosis of cancer in primary care, but barriers were identified that hindered the usability and actionability of the recommendations in practice. In response, the tool has been refined and is currently being evaluated as part of a randomized controlled trial. Successful and effective implementation of this QI tool could support the detection of patients at risk of undiagnosed cancer in primary care and assist in preventing unnecessary delays. %M 35925656 %R 10.2196/39277 %U https://formative.www.mybigtv.com/2022/8/e39277 %U https://doi.org/10.2196/39277 %U http://www.ncbi.nlm.nih.gov/pubmed/35925656