An anthropological approach to Evaluating patient and general practitioners’ experiences with an open access flexible sigmoidoscopy service in Teesside.UK

Abstract

The reported high incidence of colo-rectal cancer on Teesside UK has led to the instigation of an Open Access Flexible Sigmoidoscopy Service (OAFSS) in two National Health Service Trust hospitals on Teesside. This thesis reports on the results of my involvement, as an anthropologist, with the evaluation of the service. The issues addressed are patients' and general practitioners' satisfaction with the service, patients' and general practitioners' perceptions of why patients delay in seeking advice on rectal bleeding, and implementation and adoption by general practitioners of guidelines in general and in particular with those designed for use with the OAFSS. These topics are approached using anthropological methods, such as participant observation, in-depth patient and general practitioner qualitative interviews, a patient- centred focus group meeting, and a standardised questionnaire. This holistic methodology offers a more realistic evaluation of 'satisfaction' than do those using a standardised questionnaire alone. This also queries the meaning of 'satisfaction' and 'perceptions' in the post-modern health arena, providing a convincing demonstration of the valuable contribution anthropologists can make to evaluations of patients' and general practitioners' perceptions and experiences.