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The two‐week rule for suspected colorectal cancer: Patient experience and psychological impact

Nenna Ndukwe (Clinical and Health Psychology Service, James Cook University Hospital, Middlesbrough, UK)
David W. Borowski (Department of Surgery, University Hospital of North Tees, Hardwick, UK)
Angela Lee (Department of Surgery, University Hospital of Hartlepool, Hartlepool, UK)
Anne Orr (Department of Medicine, University Hospital of Hartlepool, Hartlepool, UK)
Sarah Dexter‐Smith (Department of Clinical Psychology, University of Teesside, Middlesbrough, UK)
Anil K. Agarwal (Clinical and Health Psychology Service, James Cook University Hospital, Middlesbrough, UK)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 6 January 2012

Abstract

Purpose

There has been considerable interest in the “two‐week rule” referral pathway efficacy for patients with suspected colorectal cancer. This study aims to explore the psychological impact on these patients.

Design/methodology/approach

Consecutive patients referred for urgent investigations under the “two‐week rule” were invited to take part in semi‐structured interviews using interpretative phenomenological analysis (IPA). Interviews were audio‐taped, transcribed verbatim and analysed using investigator triangulation to enhance data trustworthiness.

Findings

Ten out of 23 (43.5 per cent) patients consented to interviews; none were diagnosed with cancer. Four super‐ordinate themes were explored, referring to the “making sense of the threat to health”, impact on self, impact on others, reflections on the “two‐week rule” referral, and its investigative process. Participants reported their anxiety, fear, vulnerability and coping mechanisms, but also raised concerns about the communication received during the “two‐week rule” referral process. Female participants preferred a female endoscopist.

Originality/value

This study is the first of its kind exploring the psychological effects of the “two‐week rule” process for colorectal cancer, highlighting potential areas for improvement in patient information, and satisfaction with the referral process.

Keywords

Citation

Ndukwe, N., Borowski, D.W., Lee, A., Orr, A., Dexter‐Smith, S. and Agarwal, A.K. (2012), "The two‐week rule for suspected colorectal cancer: Patient experience and psychological impact", International Journal of Health Care Quality Assurance, Vol. 25 No. 1, pp. 75-85. https://doi.org/10.1108/09526861211192421

Publisher

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Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited