Tod Angela M, Craven Jacqueline, Allmark Peter
Centre for Health and Social Care Research, Sheffield Hallam University, Collegiate Campus, Sheffield, UK.
J Adv Nurs. 2008 Feb;61(3):336-43. doi: 10.1111/j.1365-2648.2007.04542.x.
This paper is a report of a study to identify factors influencing delay in reporting symptoms of lung cancer.
Lung cancer accounts for approximately 5% of deaths in the Western world. For up to 80% of patients, their disease is inoperable because it has been diagnosed too late. This suggests that reducing diagnostic delay could reduce mortality.
This qualitative study was conducted from July 2005 to May 2006 in community and hospital settings in the United Kingdom. A purposive sample of people diagnosed with lung cancer in the previous 6 months (n = 18), and two 18-month survivors took part in individual interviews.
Participants reported a range of interrelating factors that influenced delay in reporting symptoms of lung cancer. Barriers to symptom reporting included symptom experience, lack of knowledge and fear. Blame and stigma because of smoking were also prevalent influences, as well as cultural factors, non-standard patterns of healthcare utilization and underlying stoical attitudes. The only factor to emerge as helpful in overcoming delay was the role families played.
Lack of knowledge and awareness about lung cancer could be addressed by better education of the public. Social marketing is a way of developing education messages which tackle cultural influences on treatment-seeking delay. Nurses have a potential role in developing and disseminating those messages.
本文是一项关于确定影响肺癌症状报告延迟因素的研究报告。
在西方世界，肺癌约占死亡人数的5%。高达80%的患者因诊断过晚而无法进行手术治疗。这表明减少诊断延迟可降低死亡率。
这项定性研究于2005年7月至2006年5月在英国的社区和医院环境中进行。对在过去6个月内被诊断为肺癌的患者（n = 18）进行了有目的抽样，并对两名存活18个月的患者进行了个人访谈。
参与者报告了一系列相互关联的因素，这些因素影响了肺癌症状报告的延迟。症状报告的障碍包括症状体验、知识缺乏和恐惧。因吸烟导致的指责和污名化也是普遍的影响因素，还有文化因素、非标准的医疗利用模式以及潜在的坚忍态度。唯一被认为有助于克服延迟的因素是家庭所起的作用。
通过对公众进行更好的教育，可以解决对肺癌知识和认识的缺乏问题。社会营销是一种制定教育信息的方式，可解决文化因素对寻求治疗延迟的影响。护士在制定和传播这些信息方面具有潜在作用。
