Psychological factors related to delay in consultation for cancer symptoms

Abstract

This research investigated psychological characteristics associated with delay in seeking help for symptoms of rectal cancer. Sixty nine subjects reconstructed pivotal events beginning with symptom onset and ending with medical consultation, and completed the Temperament and Character Inventory (TCI) and the State-Trait Anxiety Inventory (STAI). The mean delay time was around 6 months, with about 1 out of 6 subjects waiting one year or more. Subjects estimated the lengths of two sequential segments of total time to consultation: (1) Symptom Appraisal time (from symptom onset to recognition of possible seriousness), and (2) Action Appraisal time (from recognition of seriousness to medical consultation). Symptom Appraisal time accounted for over two-thirds of total time and was associated with low scores on the TCI Harm Avoidance scale (TCI-HA), indicating dispositional insensitivity to threat, and marginally associated with less education and younger age. Action Appraisal time was not associated with any demographic or psychological variables. Low TCI-HA scores were also associated with lower likelihood of previous cancer screening, and with better judgments of premorbid health. Low STAI Trait scores were associated with better judgments of premorbid health and fewer doctor visits. Results are discussed regarding the importance of understanding dispositional characteristics related to health behavior.

The importance of contextualization. Anthropological reflections on descriptive analysis, its limitations and implications

“…Some of the interview studies on patient delay are well situated within psychological theoretical frameworks (e.g. Ristvedt & Trinkaus, 2005;Facione & Facione, 2006;Pedersen et al, 2011), and a few studies are based on theories or conceptual frameworks from the humanities or the social sciences (e.g. Alonzo, 1984;Levealahti, Tishelman & Ohlen, 2007;Andersen et al, 2010).…”

Why do People Avoid Medical Care? A Qualitative Study Using National Data

“…[5][6][7] Even individuals with major health problems 4,8,9 or who are experiencing symptoms [10][11][12] avoid seeking medical care. For example, in one study, 17% of patients diagnosed with rectal tumors reported that they waited a year or more to seek medical consultation after noticing symptoms, with some waiting up to five years.…”

“…For example, in one study, 17% of patients diagnosed with rectal tumors reported that they waited a year or more to seek medical consultation after noticing symptoms, with some waiting up to five years. 12 Avoiding medical care may result in late detection of disease, reduced survival, and potentially preventable human suffering. 1,8,13,14 In the present study, we sought to understand why people avoid seeking medical care.…”

Influential variables on the timing of help-seeking behavior in lung cancer patients.

“…These changes are evaluated by the person against their previous personal experiences either with self or someone close to them as they evaluate (Bish et al, 2005;Mason & Strauss, 2004a;Moloczij et al, 2008;Shaw, Brittain, Tansey, & Williams, 2008). Symptom appraisal time has been reported as the time period accounting for the majority of total time to seek help in other cancers secondary to attributing symptoms to something benign (Mason & Strauss, 2004a;Ristvedt & Trinkhaus, 2005).…”

“…Patient delay has pointed primarily to sociodemographic and psychological factors as influential in help-seeking behavior in multiple disease processes (Bibb, 2001;Facione, Miaskowski, Dodd, & Paul, 2002;Friedman et al, 2006;Hazewinkel et al, 2009;Ristvedt & Trinkhaus, 2005). Although the relationship between delayed help-seeking behavior and survival is not linear, delay is attributed as a variable in poor patient outcomes reflected in the survival rates of breast cancer Gould, Fitzgerald, Fergus, Clemons, & Baig, 2010;Linsell et al, 2009) and patients experiencing acute cardiovascular events (Altice & Madigan, 2011;Dracup et al, 1995;Dracup et al, 2003;FoxWasylyshyn, El-Masri, & Artinian, 2010;Fukuoka et al, 2007;Fukuoka et al, 2010;Higginson, 2008;Kaur et al, 2006;Khraim, Scherer, Dorn, & Carey, 2009;Lesneski, 2010;Perkins-Porras et al, 2009).…”