Travelling on parallel tracks: Patient and physician perspectives on why women delay seeking care for breast cancer symptoms
Abstract
In the breast cancer literature, “delayed presentation†is defined as a delay of > 3 months from the self-detection of a new breast cancer symptom until presentation to a health care provider. It has been established that early detection of breast cancer is associated with better health outcomes. The purpose of this qualitative study was to explore reasons why women delay seeking care for their breast cancer symptoms by asking both women and family physicians for their perspectives. Narrative analysis was used to reveal the ways in which people make sense of their experiences and which parts of their stories are most important to them. We found differences in the explanatory narratives of women versus those of family physicians when it came to understanding delay. Suggestions to promote earlier presentation include improving physician-patient communication and encouraging physician and health care professional neutrality in making attributions about women’s delay.
Full Text:
PDFReferences
Andersen, B.L., Cacioppo, J.T., & Roberts, D.C. (1995). Delay in
seeking a cancer diagnosis: Delay stages and psychophysiological
comparison processes. British Journal of Social Psychology, 34,
–52.
Andersen, R.S., Vedsted, P., Olesen, F., Bro, F., & Sondergaard, J.
(2009). Patient delay in cancer studies: A discussion of methods
and measures. BMC Health Services Research, 9, 189.
Arndt, V., Sturmer, T., Stegmaier, C., Ziegler, H., Becker, A., &
Brenner, H. (2003). Provider delay among patients with breast
cancer in Germany: A population-based study. Journal of Clinical
Oncology, 21(8), 1440–1446.
Beattie, A. (2009). Detecting breast cancer in a general practice: Like
findings needles in the haystack? Australian Family Physician,
(12), 1003–1006.
Bish, A., Ramirez, A., Burgess, C., & Hunter, M. (2005). Understanding
why women delay in seeking help for breast cancer symptoms.
Journal of Psychosomatic Research, 58, 321–326.
Bruner, J. (1987). Life as narrative. Social Research, 54, 11–32.
Bruner, J. (1990). Acts of meaning. London: Harvard University
Press.
Caplan, L., & Helzlsouer, K. (1992–1993). Delay in breast cancer: A
review of the literature. Public Health Review, 20, 187–214.
Cobb, B., Clark, R.L., McGuire, C., & Howe, C.D. (1954). Patientresponsible
delay of treatment in cancer, a social psychological
study. Cancer, 7, 920–926.
De Nooijer J., Lechner L., & De Vries, H. (2001). Help-seeking
behaviour for cancer symptoms: Perceptions of patients and
general practitioner. Psych-Oncology, 10, 469–478.
Davis, E. (2008). Risky business: Medical discourse, breast cancer,
and narrative. Qualitative Health Research, 18, 65–76.
Ellingson, L.L., & Buzzanell, P.M. (1999). Listening to women’s
narratives of breast cancer treatment: A feminist approach to
patient satisfaction with physician-patient communication.
Health Communication, 11, 153–183.
Facione, N.C., Miaskowski, C., Dodd, M.J., & Paul, S.M. (2002). The
self-reported likelihood of patient delay in breast cancer: New
thoughts for early detection. Preventive Medicine, 34, 397–
Fergus, K.D., Fitzgerald, B., Granek, L., Clemons, M., Zalany, L.,
& Eisen, A. (2011). Knowing and disclosure processes in the
symptom appraisal of breast cancer: A qualitative analysis
of relationship factors influencing presentation for medical
evaluation. Journal of Health Psychology, 16(4), 653–666.
Granek, L., & Fergus, K.D. (2011). Resistance, agency, and liminality in
women’s accounts of help-seeking upon discovery of an abnormal
breast symptom. Manuscript in preparation.
Heisey, R., Clemons, M., Granek, L., Fergus, K., Hum, S., Lord, B., McCready,
D., & Fitzgerald, B. (2011). Health care strategies to promote earlier
presentation of symptomatic breast cancer: Perspectives of women
and family physicians. In Press in Current Oncology.
Meechan, G., Collins. J., & Petrie, K.J. (2003). The relationship of
symptoms and psychological factors to delay in seeking medical
care for breast symptoms. Preventative Medicine, 3, 374–378.
Miles, M., & Huberman, A. (1994). Qualitative data analysis, 2nd ed.
Thousand Oakes, CA: Sage Publications.
Mishler, E.G. (1986a). The analysis of interview narratives. In T.
Sarbin (Ed.), Narrative psychology: The storied nature of human
conduct (pp. 233–255). New York: Praeger.
Mishler, E.G. (1986b). Research interviewing: Context and narrative.
Cambridge, MA: Harvard University Press.
Moore, P., Sickel, A., Malat, J., Williams, D., Jackson, J., & Adler, N.
(2004). Psychosocial factors in the medical and psychological
treatment of avoidance: The role of the doctor-patient
relationship. Journal of Health Psychology, 9, 421–433.
Nosarti, C., Crayford, T., Roberts, J.V., Elias, E., McKenzie, K., &
David, A.S. (2000). Delay in presentation of symptomatic referrals
to breast clinic: Patient and system factors. British Journal of
Cancer, 82(3), 742–748.
O’Mahoney, M., & Hegarty, J. (2009). Help seeking for cancer
symptoms: A review of the literature. Oncology Nursing Forum,
(4), E178–84.
Richards, M., Smith, P., Ramirez, A., Fentiman, I., & Rubens R.
(1999). The influence on survival of delay in the presentation
and treatment of symptomatic breast cancer. British Journal of
Cancer, 79(5–6), 858–64.
White, H. (1981). The value of narrativity in the representation of
reality. In W.J.T. Mitchell (Ed.), On narrative (pp. 1–23). Chicago,
IL: University of Chicago Press.
Refbacks
- There are currently no refbacks.


