ORIGINAL ARTICLE
The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study
C. Dobson BSc, MA, PhD,
A. Russell BA, MA, D. Phil,
S. Brown LLB, MA, PhD,
G. Rubin MB ChB, MRCGP, FRCGP, FRCP(E),
Corresponding Author
C. Dobson BSc, MA, PhD
Research Associate
Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Correspondence
Christina Dobson, Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
Email: [email protected]
Search for more papers by this authorA. Russell BA, MA, D. Phil
Associate Professor (Reader)
Department of Anthropology, Durham University, Durham, Uk
Search for more papers by this authorS. Brown LLB, MA, PhD
Lecturer, Sociology of Health and Illness
School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
Search for more papers by this authorG. Rubin MB ChB, MRCGP, FRCGP, FRCP(E)
Professor of General Practice and Primary Care
Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Search for more papers by this authorC. Dobson BSc, MA, PhD,
A. Russell BA, MA, D. Phil,
S. Brown LLB, MA, PhD,
G. Rubin MB ChB, MRCGP, FRCGP, FRCP(E),
Corresponding Author
C. Dobson BSc, MA, PhD
Research Associate
Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Correspondence
Christina Dobson, Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
Email: [email protected]
Search for more papers by this authorA. Russell BA, MA, D. Phil
Associate Professor (Reader)
Department of Anthropology, Durham University, Durham, Uk
Search for more papers by this authorS. Brown LLB, MA, PhD
Lecturer, Sociology of Health and Illness
School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
Search for more papers by this authorG. Rubin MB ChB, MRCGP, FRCGP, FRCP(E)
Professor of General Practice and Primary Care
Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Search for more papers by this authorFunding information
This study was funded by an Evaluation, Research and Development Unit (ERDU) PhD Studentship.
Abstract
Prolonged diagnostic intervals are associated with poorer outcomes, and the patient interval appears to be a substantial contributor to the overall length of the diagnostic interval. This study sought to understand how the broader context of people's lives influenced symptom appraisal and help-seeking, comparing experiences by length of the patient interval. Patients referred with a suspicion of lung or colorectal cancer were invited to complete a questionnaire about their symptoms, with 26 respondents purposively sampled to take part in a semi-structured interview about their patient intervals. Embodied experience, appraisal, help-seeking decision-making and consultation were identified as component stages of the patient interval, with the factors affecting movement between these stages located in one of four contextual domains: individual experience, interpersonal relationships, healthcare system interactions and social and temporal context. The length of the patient interval was related to the type of symptom(s) experienced, discussion of symptoms with others and the social responsibilities people held during symptomatic periods. A contextual model of the patient interval illustrates the stages and domains of this interval, as grounded in the data from this study. The model has potential application to future studies examining the patient interval for a range of symptoms.
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