Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-27T16:55:18.873Z Has data issue: false hasContentIssue false

Delay in seeking help

from Psychology, health and illness

Published online by Cambridge University Press:  18 December 2014

By
Suzanne E. Scott
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Suzanne E. Scott
Affiliation:
King's College London
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
Get access

Summary

Following the detection of a symptom, the majority of individuals do not seek professional help, but instead do nothing or self-medicate (Freer, 1980). Whilst these responses may play a useful role in limiting the burden on healthcare services for benign and minor conditions, a continuing and important issue is delay in seeking help for symptoms that are indicative of life-threatening diseases. The intention of this chapter is to summarize the theoretical approaches used to study and understand help-seeking behaviour, with particular reference to delay in seeking help for symptoms of cancer and myocardial infarction (as these have been the most widely researched areas), and finally to discuss the implications of this research.

Delay in help-seeking or ‘patient delay’ (Pack & Gallo, 1938) is the time taken from the detection of a symptom to the first consultation with a healthcare professional for that symptom. This is distinct from ‘professional delay’ (the time from the first consultation with a healthcare professional regarding a symptom to the receipt of a definitive diagnosis). The overall duration of delay has been divided in such a manner because an undifferentiated measure like ‘total delay’ (the time from the detection of a symptom to the receipt of a definitive diagnosis) may confound the effects of multiple factors that influence delay (Safer et al., 1979). For instance, the factors that hinder a patient's decision to seek help following the self-discovery of a breast lump may be quite different from those that cause a delay in reaching a definitive diagnosis of breast cancer following the first consultation with a healthcare professional.

Type
Chapter
Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 70 - 74
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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, 33–52.Google Scholar
Andersen, R. (1968). A behavioral model of families' use of health services, Research Series No. 25. Chicago: Centre for Health Administration Studies, University of Chicago.
Burgess, C. C., Ramirez, A. J., Richards, M. A. & Love, S. B. (1998). Who and what influences delayed presentation in breast cancer?British Journal of Cancer, 77, 1343–48.Google Scholar
Cacioppo, J. T., Andersen, B. L., Turnquist, D. C. & Petty, R.E. (1986). Psychophysiological comparison processes: interpreting cancer symptoms. In Anderson, B. L.. (Ed.). Women with cancer: psychological Perspectives. New York: Springer-Verlag.
Corney, R. H. (1990). Sex differences in general practice attendance and help-seeking for minor illness. Journal of Psychosomatic Research, 34, 525–34.Google Scholar
Nooijer, J., Lechner, L. & Vries, H. (2001). A qualitative study on detecting cancer symptoms and seeking medical help; an application of Andersen's model of total patient delay. Patient Education and Counselling, 42, 145–57.Google Scholar
Department of Health. (2000). Press release: reference 2000/0187. London: DoH.
Dignan, M., Michielutte, R., Sharp, P., Bahnson, J., Young, L. & Beal, P. (1990). The role of focus groups in health education for cervical cancer among minority women. Journal of Community Health, 15, 369–75.Google Scholar
Facione, N. C. (1993). Delay versus help seeking for breast cancer symptoms: a critical review of the literature on patient and provider delay. Social Science and Medicine, 36, 1521–34.Google Scholar
Fisher, S. (1967). Motivation for patient delay. Archives of General Psychiatry, 16, 676–8.Google Scholar
Francome, C. (2000). Improving men's health. London: Middlesex University Press.
Freer, C. B. (1980). Self-care: a health diary study. Medical Care, 18, 853–61.Google Scholar
Friedson, E. (1961). Patients' view of medical practice. New York: Russell Sage Foundation.
Galdas, P. M., Cheater, F. & Marshall, P. (2005). Men and health help-seeking behaviour: literature review. Journal of Advanced Nursing, 49, 616–23.Google Scholar
Godfrey-Faussett, P., Kaunda, H., Kamanga, J.et al. (2002). Why do patients with a cough delay seeking care at Lusaka urban health centres? A health systems research approach. International Journal of Tuberculosis and Lung Disease, 6, 796–805.Google Scholar
Gruppo Italiano per lo Studio della Stretochinasi nell'Infarto Miocardico (GISSI). (1986). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet, 8478, 397–402.
Guggenheimer, J., Verbin, R. S., Johnson, J. T., Horkowitz, C. A. & Myers, E. N. (1989). Factors delaying the diagnosis of oral and oropharyngeal carcinomas. Cancer, 64, 932–5.Google Scholar
Henderson, J. G. (1965). Denial and repression as factors in the delay of patients with cancer presenting themselves to the physician. Annals of the New York Academy of Sciences, 125, 856–64.Google Scholar
Herlitz, J., Hartford, M., Blohm, M.et al. (1989). Effect of a media campaign on delay times and ambulance use in suspected acute myocardial infarction. American Journal of Cardiology, 64, 90–3.Google Scholar
Hills, S. D., Joesoef, R., Marchbanks, P. A.et al. (1993). Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility. American Journal of Obstetrics and Gynecology, 168, 1503–9.Google Scholar
Horne, R., James, D., Petrie, K., Weinman, J. & Vincent, R. (2000). Patients' interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction. Heart, 83, 388–93.Google Scholar
Leventhal, H. (1970). Findings and theory in the study of fear communications. Advances in Experimental Social Psychology 5, 119.Google Scholar
McClean, H. L. & Reid, M. (1997). Use of gum services and information and views held by first time service users in a large UK city: implications for information provision. International Journal of STD and AIDS, 8, 154–8.Google Scholar
Mechanic, D. (1978). Medical Sociology (2nd edn.). New York: The Free Press.
Mechanic, D. (1982). The epidemiology of illness behaviour and its relationship to physical and psychological distress. In Mechanic, D.. (Ed.). Symptoms, illness behaviour and help-seeking. New York: Prodist Press.
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, 36, 374–8.Google Scholar
Moore, P. J., Sickel, A. E., Malat, J., Williams, D. & Alder, N. E. (2004). Psychosocial factors in medical and psychological treatment avoidance: the role of the doctor-patient relationship. Journal of Health Psychology, 9, 421–33.Google Scholar
Mor, V., Masterson-Allen, S., Goldber, R., Guaagnoli, E. & Wool, M. S. (1990). Pre-diagnostic symptom recognition and help seeking among cancer patients. Journal of Community Health, 15, 253–66.Google Scholar
Neave, L. M., Mason, B. H. & Kay, R. G. (1990). Does delay in diagnosis of breast cancer affect survival?Breast Cancer Research and Treatment, 15, 103–8.Google Scholar
Nosarti, C., Crayford, T., Roberts, J. V.et al. (2000). Delay in presentation of symptomatic referrals to a breast clinic: patient and system factors. British Journal of Cancer, 82, 742–8.Google Scholar
Onizawa, K., Nishihara, K., Yamagata, K., Yusa, H., Yanagawa, T. & Yoshida, H. (2003). Factors associated with diagnostic delay of oral squamous cell carcinoma. Oral Oncology, 39, 781–8.Google Scholar
Office of Population Censuses and Surveys, (1991). General Household Survey. London: Her Majesty's Stationary Office.
Pack, G. T. & Gallo, J. S. (1938). The culpability for delay in the treatment of cancer. American Journal of Cancer, 33, 443.Google Scholar
Pattenden, J., Watt, I., Lewin, R. J. & Stanford, N. (2002). Decision making processes in people with symptoms of acute myocardial infarction: qualitative study. British Medical Journal, 324, 1006–9.Google Scholar
Penchansky, R. & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19, 127–40.Google Scholar
Ramirez, A. J., Westcombe, A. M., Burgess, C. C.et al. (1999). Factors predicting delayed presentation of symptomatic breast cancer: a systematic review. Lancet, 353, 1127–31.Google Scholar
Rogers, A., Chapple, A. & Sergison, M. (1999). “If a patient is too costly they tend to get rid of you”: the impact of people's perceptions of rationing on the use of primary care. Health Care Analysis, 7, 225–37.Google Scholar
Rossi, S., Cinini, C.Di Pietro, C.et al. (1990). Diagnostic delay in breast cancer: correlation with disease stage and prognosis. Tumori, 76, 559–62.Google Scholar
Ruston, A., Clayton, J. & Calnan, M. (1998). Patients' action during their cardiac event: qualitative study exploring differences and modifiable factors. British Medical Journal, 316, 1060–4.Google Scholar
Safer, M. A., Tharps, Q. J., Jackson, T. C. & Leventhal, H. (1979). Determinants of three stages of delay in seeking care at a medical clinic. Medical Care, 17, 11–29.Google Scholar
Scambler, G. & Scambler, A. (1984). The illness iceberg and aspects of consulting behaviour. In Fitzpatrick, J.H.R., Newman, S., Scambler, G. & Thompson, J. (Eds.). The Experience of illness. London: Tavistock Publications.
Scott, S. E., Grunfeld, E. A., Main, J. & McGurk, M. (2006). Patient delay in oral cancer: a qualitative study of patients' experiences. Psycho-Oncology, 15, 474–85.
Sheikh, I. & Ogden, J. (1998). The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach. Patient Education and Counselling, 35, 35–42.Google Scholar
Simoons, M. L., Serruys, P. W., Brand, M.et al. (1986). Early thrombolysis in acute myocardial infarction: limitation of infarct size and improved survival. Journal of the American College of Cardiology, 7, 717–28.Google Scholar
Timko, C. (1987). Seeking medical care for a breast cancer symptom: determinants of intentions to engage in prompt or delay behavior. Health Psychology, 6, 305–28.Google Scholar
Zola, I. K. (1973). Pathways to the doctor – from person to patient. Social Science and Medicine, 7, 677–89.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×