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British Journal of General Practice

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Wales Interventions and Cancer Knowledge about Early Diagnosis (WICKED): findings of work package 2 of the WICKED research programme

Sadia Nafees, Rebecca-Jane Law, Maggie Hendry, Julia Hiscock, Marian A Stanciu, Ruth Lewis, Alun Surgey, Nia Goulden, Zoe Hoare, Katherine Brain, Stephanie Smits, Seow T Yeo, Rhiannon Tudor Edwards, Lynne Williams, Nefyn Williams, Clare Wilkinson and Richard D Neal
British Journal of General Practice 2018; 68 (suppl 1): bjgp18X697433. DOI: https://doi.org/10.3399/bjgp18X697433
Sadia Nafees
North Wales Centre for Primary Care Research, Bangor University, Bangor Email:
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  • For correspondence: s.nafees@bangor.ac.uk
Rebecca-Jane Law
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Maggie Hendry
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Julia Hiscock
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Marian A Stanciu
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Ruth Lewis
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Alun Surgey
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Nia Goulden
North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor
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Zoe Hoare
North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor
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Katherine Brain
Division of Population Medicine, School of Medicine, Cardiff University, Cardiff
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Stephanie Smits
Division of Population Medicine, School of Medicine, Cardiff University, Cardiff
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Seow T Yeo
Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor
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Rhiannon Tudor Edwards
Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor
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Lynne Williams
School of Healthcare Sciences, Bangor University, Bangor
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Nefyn Williams
Department of Health Services Research, University of Liverpool, Liverpool
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Clare Wilkinson
North Wales Centre for Primary Care Research, Bangor University, Bangor
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Richard D Neal
Academic Unit of Primary Care, Institute of Health Sciences, University of Leeds, Leeds
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Abstract

Background Cancer outcomes in the UK are worse than many countries with similar health structures. GPs play a pivotal role in improving cancer outcomes through earlier diagnosis.

Aim To develop and evaluate a behavioural intervention to enable GPs to expedite cancer diagnosis.

Method This ongoing programme is divided into four inter-related Work Packages (WPs) using a mixed methods approach. WP 2 comprises an all-Wales online GP questionnaire, 20 GP telephone interviews, and 4 practice-team focus groups. The questionnaire examined GPs’ perceptions and attitudes towards cancer diagnosis, and influences on cancer referral-related behaviour change. GPs’ individual beliefs and behaviours were explored in interviews; practice systems and norms were investigated in focus groups. Quantitative data were analysed descriptively, with conventional content analysis for free-text responses, and Framework analysis was used for qualitative data-sets.

Results Early findings show that 269/1993 (13.5%) GPs completed the survey. Most agreed that ‘timelier diagnosis leads to better survival’, perceived themselves to be knowledgeable, confident and capable in managing cancer symptoms, reported recent changes in their cancer-related diagnostic activity, and believed in their ability to influence timely diagnosis. However, many thought that, if given the opportunity and support, there was still room to improve early cancer diagnosis. Preliminary analysis of six interviews revealed 5 themes including; ‘wanting referral behaviour to fit, ‘feeling untrusted by secondary care’, ‘practicing over-defensive medicine’, ‘support from colleagues, and ‘difficulty referring patients with vague symptoms’.

Conclusion These findings will inform the development (WP3), and evaluation (WP4) of a behavioural intervention to expedite referral and diagnosis.

  • © British Journal of General Practice 2018
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British Journal of General Practice: 68 (suppl 1)
British Journal of General Practice
Vol. 68, Issue suppl 1
June 2018
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Wales Interventions and Cancer Knowledge about Early Diagnosis (WICKED): findings of work package 2 of the WICKED research programme
Sadia Nafees, Rebecca-Jane Law, Maggie Hendry, Julia Hiscock, Marian A Stanciu, Ruth Lewis, Alun Surgey, Nia Goulden, Zoe Hoare, Katherine Brain, Stephanie Smits, Seow T Yeo, Rhiannon Tudor Edwards, Lynne Williams, Nefyn Williams, Clare Wilkinson, Richard D Neal
British Journal of General Practice 2018; 68 (suppl 1): bjgp18X697433. DOI: 10.3399/bjgp18X697433

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Wales Interventions and Cancer Knowledge about Early Diagnosis (WICKED): findings of work package 2 of the WICKED research programme
Sadia Nafees, Rebecca-Jane Law, Maggie Hendry, Julia Hiscock, Marian A Stanciu, Ruth Lewis, Alun Surgey, Nia Goulden, Zoe Hoare, Katherine Brain, Stephanie Smits, Seow T Yeo, Rhiannon Tudor Edwards, Lynne Williams, Nefyn Williams, Clare Wilkinson, Richard D Neal
British Journal of General Practice 2018; 68 (suppl 1): bjgp18X697433. DOI: 10.3399/bjgp18X697433
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