Healthcare Avoidance

Abstract

The purpose of this study is to provide a critical review and synthesis of theoretical and research literature documenting the impact of avoidance on healthcare behaviors, identify the factors that influence healthcare avoidance and delay in the adult population, and propose a direction for future research. The Theory of Reasoned Action, Theory of Planned Behavior, Theory of Care-Seeking Behavior, the Transtheoretical Model, and the Behavioral Model of Health Services Use/Utilization are utilized to elaborate on the context within which individual intention to engage in healthcare behaviors occurs. Research literature on the concept of healthcare avoidance obtained by using computerized searches of CINAHL, MEDLINE, PSYCH INFO, and HAPI databases, from 1995 to 2007, were reviewed. Studies were organized by professional disciplines. Healthcare avoidance is a common and highly variable experience. Multiple administrative, demographic, personal, and provider factors are related to healthcare avoidance, for example, distrust of providers and/or the science community, health beliefs, insurance status, or socioeconomic/income level. Although the concept is recognized by multiple disciplines, limited research studies address its impact on healthcare decision making. More systematic research is needed to determine correlates of healthcare avoidance. Such studies will help investigators identify patients at risk for avoidant behaviors and provide the basis for health-promoting interventions. Methodological challenges include identification of characteristics of individuals and environments that hinder healthcare behaviors, as well as, the complexity of measuring healthcare avoidance. Studies need to systematically explore the influence of avoidance behaviors on specific healthcare populations at risk.

Health and health belief factors associated with screening and help‐seeking behaviours for breast cancer: A systematic review and meta‐analysis of the European evidence

“…The distinction is not always clear, however, as some people who are aware of a symptom may choose to wait for their next routine screening to have this investigated, in which case screening becomes part of the help-seeking process (Solbjør, Skolbekken, Saetnan, Hagen, & Forsmo, 2012). They can, however, be considered together as they are both practices to enable early detection and are both potential health care-avoiding actions (Byrne, 2008). Breast cancer is detected in only a very small number of routine screening appointments (8.4 per 1,000 women; NHS Digital, 2019), and following help-seeking, a large number (9 out of 10) of GP referrals for breast lumps result in an outcome that is non-cancerous (Cancer Research UK, 2017).…”

“…Breast cancer is detected in only a very small number of routine screening appointments (8.4 per 1,000 women; NHS Digital, 2019), and following help-seeking, a large number (9 out of 10) of GP referrals for breast lumps result in an outcome that is non-cancerous (Cancer Research UK, 2017). The possibility of a diagnosis of breast cancer may lead to increased anxiety, which promotes prompt health care utilization or screening attendance; however, as such a diagnosis carries a high personal threat, it can also lead to avoidance behaviour (Byrne, 2008;Rogers, 1975). In addition, women who demonstrate a longer time to presentation are also less likely to participate in screening (Heisey et al, 2011).…”

Stigma in Practice: Barriers to Health for Fat Women

“…For fat patients, the delay to access healthcare services may be explained by a range of factors that can often be attributed to healthcare avoidance (Bryne, 2008). These include avoidance of inadequate equipment such as gowns that are too small, exam tables/areas that are too small, and blood pressure cuffs that do not fit (Thompson and Thomas, 2000; Amy et al, 2006; Merrill and Grassley, 2008; Ingraham et al, 2014).…”

Health-Care Delay in Malignant Melanoma: Various Pathways to Diagnosis and Treatment

“…In the health-care organization, reasons for late diagnosis of cancer in general have been related to accessibility, difficulties and complexity in procedures of diagnosis and incorrect referrals [8–12]. Despite its importance, reasons for health-care and doctor's delay in MM have been only sparsely investigated.…”