Experience of health changes and reasons for delay in seeking care: A UK study of the months prior to the diagnosis of lung cancer
Experience of health changes and reasons for delay in seeking care: A UK study of the months prior to the diagnosis of lung cancer
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DOI：
10.1016/j.socscimed.2005.08.012
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发表时间：
2006-03-01
影响因子：
5.4
通讯作者：
Roffe, L
中科院分区：
文献类型：
--
作者：
Corner, J;Hopkinson, J;Roffe, L
由于出现症状的个人迟到或医生或医院系统故障而导致癌症诊断“延迟”的问题目前受到密切关注，作为减少癌症死亡的更广泛举措的一部分。然而，对于肺癌，人们普遍认为“晚期”诊断是不可避免的，因为在早期阶段检测疾病存在生物医学困难。报道了对 22 名最近被诊断患有可手术（早期）和不可手术（晚期）肺癌的个体进行的访谈研究中回忆的诊断前事件的数据。调查结果显示，个人，无论其疾病阶段或社会背景如何，都无法认识到他们在最终诊断为严重且需要医疗护理之前的几个月内经历的症状。症状，即使很严重，也被归因于日常原因，并不被解释为健康状况不佳的表现。有些人不愿意就症状寻求帮助，因为他们不确定自己所经历的情况是否正常，在一个案例中，因为作为吸烟者，个人觉得“不值得”接受医疗护理。这项研究表明，之前关注癌症诊断延迟过程中的个人或心理因素的假设需要重新审视，并且应该考虑可能影响肺癌患者诊断时间的更广泛的社会影响。 (c) 2005 Elsevier Ltd. 保留所有权利。
The problem of 'delay' in diagnosing cancer as a result of late presentation by individuals who have symptoms, or through doctor or hospital system failures, are currently the subject of close attention as part of broader initiatives to reduce deaths from cancer. However, in lung cancer there has been a generally held view that 'late' diagnosis is inevitable because of the biomedical difficulties in detecting the disease at an early stage. Data about events recalled prior to diagnosis from an interview study with 22 individuals recently diagnosed with operable (early stage) and inoperable (late stage) lung cancer are reported. Findings reveal that individuals, regardless of their disease stage, or their social background failed to recognise symptoms that they experienced over many months prior to their eventual diagnosis as serious and warranting medical attention. Symptoms, even when severe, were instead attributed to everyday causes and were not interpreted as indicative of ill-health. There was a reluctance to seek help for symptoms among some because they were unsure whether what they were experiencing was normal or not, and in one case because as a smoker, the individual felt 'unworthy' of medical care. This study suggests that previous assumptions that focus on individual or psychological factors in the processes of delay in cancer diagnosis need revisiting and the broader social influences that may affect the timing of diagnosis among people with lung cancer should be considered. (c) 2005 Elsevier Ltd. All rights reserved.