Meechan Geraldine, Collins John, Petrie Keith
Department of Health Psychology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
N Z Med J. 2002 Nov 22;115(1166):U257.
To investigate the extent of patient delay in new patients with self-detected breast symptoms referred to a specialist breast clinic. To examine the association between delay and sociodemographic factors, the practice of breast self-examination (BSE), how the breast symptom was discovered, and personal experience of breast cancer in family and friends.
Eighty five women referred to the South Auckland Health Breast Clinic completed a questionnaire and interview after arrival at the clinic and prior to their consultation with the medical specialist. Delay was measured as the time interval between initial self-detection of a breast symptom and first contact with a general practitioner (GP) for evaluation of the symptom. Analysis of patient characteristics and delay time was conducted using Pearson product moment correlations, t-test for independent samples and one way analysis of variance (ANOVA) where appropriate.
The median delay time between initial breast symptom detection and seeing a GP was 14 days. Of the total sample of 85 women, 40% had seen their doctor within 7 days, 52% within 14 days, 69% within 30 days, and 14% had waited over 90 days. Delay time was not significantly associated with any sociodemographic factors. No difference in delay time was found between the ethnic groups of European, Maori or Pacific women. No difference in delay was shown between those women who performed regular BSE and those who did not. However, women who discovered their breast symptom by chance or through BSE had a shorter delay time than women experiencing breast pain. Although experience of a friend or family member with breast cancer was not significantly associated with delay, there was a trend for women who had a family member with breast cancer to have a longer delay time before seeing their GP.
This study is the first in New Zealand to investigate the extent of patient delay for women with self-detected breast symptoms and the factors influencing this delay. The majority of women saw their doctor within one month of self-detection of a breast symptom, however 14% delayed over three months before seeing their GP. Women who had a family member with breast cancer tended to respond to their breast symptom by delaying seeking medical attention, suggesting that risk perceptions of developing breast cancer may influence delay times in seeking medical help. Results from this study are taken from women referred by their GP to a specialist breast clinic. Certainly, further clarification of the factors that influence delay involving broader patient groups is vital to the development of public education initiatives aiming to encourage women to seek prompt medical evaluation of breast symptoms.
调查自我发现乳房症状的新患者转诊至专科乳腺诊所时患者延迟的程度。研究延迟与社会人口统计学因素、乳房自我检查(BSE)的实践、乳房症状的发现方式以及家人和朋友的乳腺癌个人经历之间的关联。
转诊至南奥克兰健康乳腺诊所的85名女性在抵达诊所后、与医学专家会诊前完成了一份问卷并接受了访谈。延迟时间以首次自我发现乳房症状与首次联系全科医生(GP)评估症状之间的时间间隔来衡量。在适当的情况下,使用Pearson积差相关、独立样本t检验和单因素方差分析(ANOVA)对患者特征和延迟时间进行分析。
从最初发现乳房症状到看全科医生的中位延迟时间为14天。在85名女性的总样本中,40%的女性在7天内看了医生,52%在14天内,69%在30天内,14%等待了超过90天。延迟时间与任何社会人口统计学因素均无显著关联。欧洲、毛利或太平洋族裔女性之间的延迟时间没有差异。定期进行乳房自我检查的女性和未进行乳房自我检查的女性之间在延迟时间上没有差异。然而,偶然发现或通过乳房自我检查发现乳房症状的女性比经历乳房疼痛的女性延迟时间更短。虽然朋友或家人患乳腺癌的经历与延迟没有显著关联,但有家庭成员患乳腺癌的女性在看全科医生之前延迟时间有延长的趋势。
本研究是新西兰首次调查自我发现乳房症状的女性患者延迟的程度以及影响这种延迟的因素。大多数女性在自我发现乳房症状后的一个月内看了医生,然而14%的女性在看全科医生之前延迟了三个月以上。有家庭成员患乳腺癌的女性倾向于通过延迟寻求医疗帮助来应对乳房症状,这表明对患乳腺癌风险的认知可能会影响寻求医疗帮助的延迟时间。本研究结果来自全科医生转诊至专科乳腺诊所的女性。当然,进一步阐明影响延迟的因素,涉及更广泛的患者群体,对于制定旨在鼓励女性对乳房症状进行及时医疗评估的公共教育举措至关重要。