Self-reported symptoms and healthcare seeking in the general population -exploring “The Symptom Iceberg”

Abstract

BackgroundResearch has illustrated that the decision-making process regarding healthcare seeking for symptoms is complex and associated with a variety of factors, including gender differences. Enhanced understanding of the frequency of symptoms and the healthcare seeking behaviour in the general population may increase our knowledge of this complex field.The primary objective of this study was to estimate the prevalence of self-reported symptoms and the proportion of individuals reporting GP contact, in a large Danish nationwide cohort. A secondary objective was to explore gender differences in GP contacts in response to experiencing one of the 44 predefined symptoms.MethodsA Danish nationwide cohort study including a random sample of 100,000 individuals, representative of the adult Danish population aged 20 years or above. A web-based questionnaire survey formed the basis of this study. A total of 44 different symptoms covering a wide area of alarm symptoms and non-specific frequently occurring symptoms were selected based on extensive literature search. Further, items regarding contact to the GP were included. Data on socioeconomic factors were obtained from Statistics Denmark.ResultsA total of 49,706 subjects completed the questionnaire. Prevalence estimates of symptoms varied from 49.4 % (24,537) reporting tiredness to 0.11 % (54) reporting blood in vomit. The mean number of reported symptoms was 5.4 (men 4.8; women 6.0).The proportion of contact to the GP with at least one symptom was 37 %. The largest proportion of GP contacts was seen for individuals reporting blood in the urine (73.2 %), whereas only 11.4 % of individuals with increase in waist circumference reported GP contact. For almost 2/3 of the symptoms reported, no gender differences were found concerning the proportion leading to GP contacts.ConclusionPrevalence of symptoms and GP contacts are common in this overview of 44 different self-reported symptoms. For almost 2/3 of the reported symptoms no gender differences were found concerning the proportion leading to GP contacts. An enhanced understanding of healthcare seeking decisions may assist healthcare professionals in identifying patients who are at risk of postponing contact to the GP and may help development of health campaigns targeting these individuals.

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

“…Back pain ranked second in women and third in men. This is consistent with previous population-based studies reporting musculoskeletal symptoms as the most prevalent symptoms38 39 or among the most prevalent symptoms4 5 8 in older adults.…”

“…Not only did a limited number of population-based studies investigated this issue, many of these focused on middle-aged adults4–8 or even exclusively on middle-aged women 910 Similarly, many studies on older people focused on a single symptom such as back pain,11 neuropsychiatric,12 anxiety13 or urinary14 symptoms.…”

Gynecological cancer alarm symptoms: is contact with specialist care associated with lifestyle and socioeconomic status? A population‐based study

“…However, there may be other differences between respondents and nonrespondents. An overall responder analysis of the entire study cohort including both genders showed that respondents were more often cohabiting, had higher educational levels, had higher income, were attached to the workforce and of Danish origin . If this is the case for the women in particular, the results of this study will most likely underestimate the true differences found.…”

Estimation of the actual disease burden of human H7N9 infection in Jiangsu of eastern China from March 2013 to September 2017

“…Most laboratory-confirmed H7N9 cases were severe infections [3,25] , which could partly be attributed to the absence of mild infection report to the medical facilities, inadequate coverage of pathogen testing on attended mild and moderate infections due to excessive workload, and the lack of an efficient diag- nostic method, such as point-of-care testing. The iceberg phenomenon of reported H7N9 cases [26][27] led to an underestimation of the burden of this disease.…”