Help-seeking among people with symptoms of lung or colorectal cancer : experience and social context

摘要: The UK has some of the poorest cancer outcomes in Europe, commonly attributed to diagnostic delays. patient interval appears be a substantial contributor these, with awareness raising campaigns key strategy for encouraging earlier presentation. However, research identified number barriers help-seeking beyond awareness, such as fear, concerns about wasting doctor’s time, personal commitments and access. This sought explore social context people symptoms lung or colorectal cancer, comparing experiences prompt consulters those who prolonged 164 completed questionnaire on symptom experience 26 these took part follow-up semi-structured interviews. People bleeding pain had shorter intervals than experiencing other symptoms. Those which were perceived severe body state deviations decided seek help much quicker general systemic symptoms, instead reappraised over time. Symptom appraisal processes informed by numerous contributory elements, drawn from four contextual domains person's life; individual experience, interpersonal relationships, health care system interactions temporal context. They included micro-level exposure carcinogens well macro-level factors, like discourses morality, calling into question centrality awareness-raising encourage presentation among symptomatic population. A novel model Contextual Model Patient Interval, is presented illustrate this pathway. The concept risk used explain how assess necessity threshold tolerability introduced means explaining timing decision making, based elements burden. assessment one element explored detail its incorporation calculations considered. idea 'critical incidents' consulted quickly 'cancer candidacy' being assessments undertaken intervals. In line societal focus generally, public developments have now resulted shift away contagion treatment, towards prediction prevention, under 'new health' approach. prevention created an environment 'early presentation' 'good patient' emerged. These place moral obligations relation acceptable responses need present oneself patient', are through examples 'time wasting', Be Clear Cancer campaign, discrepant reports length study.