Ietje Perfors

34 Chapter 2 Discussion Summary In the present study, we evaluated the needs of (former) patients for GP involvement in cancer care. More than half of the respondents reported that they wanted the GP to be involved in cancer care after the diagnosis. Presently, the need for GP involvement is met in over three-quarter of the cases. As for GP involvement in SDM of cancer treatment, the balance is different. Although more than 80% expressed a need for the GP to listen to worries and considerations, this was only met in almost half of these cases. In parallel, more than two-thirds of responding cancer patients indicated a need for GP involvement in several elemental SDM steps, such as explaining information, checking understanding and discussing priorities. This SDM support happened in a small minority of cases. Finally, the initiator of GP involvement was mostly the patient, whereas satisfaction with GP involvement in cancer care was higher if the GP was the initiator. Strengths and limitations Using a survey to assess the presence of needs in retrospect has several limitations. Recall biasmay have occurred, since themedian interval between last received treatment and participation was two years. Remembering needs, and whether these were met, may be hard after a relatively long and arduous period. Among those treated longer ago (≥3years) the reported needs were similar, but the unmet needs were slightly higher compared to those who were more recently treated (≤2years). This could either indicate that unmet needs are overestimated after a longer period of time, or that these needs are increasingly met. Also, the method used to recruit cancer patients may have caused selection of participants. The survey was distributed among a group of (former) cancer patients who are mostly affiliated to a cancer patient organisation. Consequently, our respondents may have been relatively committed, active and critical, thus may have different needs than the average cancer patient and have a stronger drive to meet those needs. This might have resulted in either an over- or underestimation of the presence of needs and the percentage of unmet needs. On one hand those who have a higher potential to meet their needs may be overrepresented. On the