在被诊断为妇科癌患者的女性中，省略盆腔检查（PE）与诊断延误有关。然而，GP往往并未进行PE。为了确定GP对PE的作用、PE的障碍因素与促进因素的感知以及GP在实践中的PE经验，进行了定性半结构化访谈研究。该研究在苏格兰一个人口约为50万的卫生委员会内进行，包括城市和农村地区。访谈于2019年3月至6月之间进行，采用面对面或电话采访方式。使用COM-B行为改变模型的能力、机会和动机的概念进行框架分析，数据与COM-B框架的三个领域兼容。能力与技能的培训和维护有关。这超越了进行检查的范围，还包括可靠地解释检查结果。机会与临床环境和检查保护人的提供有关。访谈对象描述了与PE相对或反对的广泛动机，与能力或机会不相关，而都与提供高质量护理有关。这是以不同的方式定义的：“为个体做最好的事情”、“医生进行检查”和“GP作为实用主义者”。GP进行或不进行可能具有潜在癌症症状的女性的PE的原因很复杂。COM-B框架提供了一种理解这种复杂性的方法。增加PE的使用和对其不使用的批评需要考虑这些多种原因。©作者。

Omission of pelvic examination (PE) has been associated with diagnostic delay in women diagnosed with gynaecological cancer. However, PEs are often not carried out by GPs.To determine the perceptions of GPs about the role of PEs, the barriers to and facilitators of PEs, and GPs' experience of PEs in practice.Qualitative semi-structured interview study conducted in one health board in Scotland (mixed urban and rural) with an approximate population of 500 000.Interviews were conducted face-to-face or by telephone between March and June 2019. Framework analysis used the COM-B behaviour change model concepts of capability, opportunity, and motivation.Data was compatible with all three domains of the COM-B framework. Capability related to training in and maintenance of skills. These went beyond carrying out the examination to interpreting it reliably. Opportunity related to the clinical environment and the provision of chaperones for intimate examination. Interviewees described a range of motivations towards or against PEs that were unrelated to either capability or opportunity. These all related to providing high-quality care, but this was defined in different ways: 'doing what is best for the individual', 'doctors examine', and 'GPs as pragmatists'.GPs' reasons for carrying out, or not carrying out, PEs in women with symptoms potentially indicating cancer are complex. The COM-B framework provides a way of understanding this complexity. Interventions to increase the use of PEs, and critics of its non-use, need to consider these multiple factors.© The Authors.