[How are we to support the sick and their relatives and how are we to give difficult information?].
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Biomedical subjects
Publications and source records attributed to A M Gravgaard.
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OBJECTIVE: To improve general practice (GP) trainees' knowledge of and attitudes towards oncology and their management of cancer patients. METHOD: A prospective study of 33 GP trainees who, after a first assessment, were randomized either to attend a two-year cancer course (n = 17) or to a control group (n = 16). Both groups were tested at the beginning (pretest) and end (post-test) of the two years. The maximum possible score was 76. All tests were corrected blindly by an oncologist and a general practitioner. RESULTS: The intervention group showed significant post-test-pretest improvements in the domains "knowledge" (mean difference 2.6, 95% CI 1.3-3.8) and "attitudes" (mean difference 2.9, 95% CI 0.8-5.0), but not in "patient management" (mean difference 0.3, 95% CI -0.6-1.2). There was no significant change in the test scores of the controls. The total mean (post-test-pretest) differences were 8.3 (95% CI 4.9-11.6 for the intervention group and -1.4 (95% CI -4.1-1.3) for the controls. CONCLUSION: A low-intensity two-year cancer course improved the knowledge and attitudes of GP trainees. Patient management, however, was not improved and may be more suited for hospital training. The current five-year specific training in general practice in Sweden seemed to be of limited value in the field of oncology. Thus, there is a need for further development of educational tools for cancer training of GP trainees, at least in Sweden.
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In a primary health care district in southern Sweden, a programme was launched to treat terminally ill cancer patients in their own homes, on the lines of the hospice mode. The quality of life of these patients has been found to be improved, and the cost to the community to be less than that of institutionalised hospital care. Other patient categories that might benefit from this form a care are those with AIDS, severe neurological diseases, or chronic cardiac or respiratory insufficiency.