Barriers to Seeking Help for Skin Cancer Detection in Rural Australia

Abstract

This study explores rural South Australians’ barriers to help-seeking for skin cancer detection. A total of 201 randomly selected rural adults (18–94 years, 66% female) were presented with a skin-cancer-related scenario via telephone and were asked the extent to which various barriers would impede their help-seeking, based on an amended version of the Barriers to Help-Seeking Scale. Older (≥63 years) and less educated participants endorsed barriers more strongly than their younger, more educated counterparts in the following domains; “Concrete barriers and distrust of caregivers”, “Emotional control”, “Minimising problem and Normalisation”, “Need for control and self-reliance” (every domain other than “Privacy”). Socioeconomic disadvantage, gender, and farmer status did not predict stronger overall barriers, but some gender and occupation-related differences were detected at the item level. Farmers were also more likely to endorse the “Minimising problem and normalization” domain than their non-farmer working rural counterparts. Widely endorsed barriers included the tendency to minimise the problem, a desire to remain in control/not be influenced by others, reluctance to show emotion or complain, and having concerns about privacy or waiting times.

Understanding variation in men’s help-seeking for cancer symptoms: A semistructured interview study.

“…Differences in cancer incidence and help-seeking between urban and rural environments may be due to aforementioned access difficulties, as well as cultural factors. These include occupational differences, unique attitudes towards health and help-seeking found among people living in rural areas (Emery et al, 2013;Fennell et al, 2017), and hegemonic rural masculinity (Alston & Kent, 2008;Courtenay, 2000). In the case of the latter, conformity to dominant rural masculinity positions men as hard working, physically tough, self-reliant, and stoic (Alston & Kent, 2008).…”

“…For example, Emery et al (2013) and Fennell et al (2017) found aspects of rural identity, including optimism, stoicism, machismo, and self-reliance contributed to rural men's delayed help-seeking.…”

Post-diagnosis skin cancer follow-up in rural general practice: A mixed-method study

“…Fennell et al reported being older (>63 years) and less educated were barriers for people seeking help for skin cancer detection in rural Australia. 22 The majority of participants in the current study agreed that patient education, continuing medical education of GPs and registrars on skin cancer, and having effective recall systems were important to improve skin cancer follow-up. Based on the findings, it would be beneficial for rural GPs to review and/or establish follow-up strategies suited to rural populations for both NMSC and melanoma skin cancers.…”

Help‐seeking behaviour for cancer symptoms: an evolutionary concept analysis

“…Help‐seeking behaviour is a term which is used in different contexts. Its most commonly used surrogate terms in the context of cancer are seeking help 23,24, seeking medical help 25,26 and medical help‐seeking 9,27.…”

“…Correct interpretation of symptoms and their attribution to cancer are facilitators to HSB (3,13,40), while misinterpretation of symptoms and their attribution to normal conditions or benign problems are barriers to HSB (15,37,41,42). Moreover, old age (16,(43)(44)(45), young age (23,28,32,33), marriage (46,47), low education level (16,27,37), positive family history of cancer (39,(48)(49)(50), fear over cancer (10,15,39,51), low perceived threat (3,15) and symptom disclosure to significant others (7,15,48,52) can act as both facilitators and barriers to HSB ( Table 1).…”