Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain.
Health Psychol Rev. 2020 Jun;14(2):245-268. doi: 10.1080/17437199.2019.1641425. Epub 2019 Aug 27.
The time patients wait before seeking help for cancer symptoms is among the most important factors contributing to diagnostic delays in cancer. We reviewed the association between time to help-seeking and three psychological factors: symptom knowledge, symptom interpretation, and beliefs about cancer. Forty-seven studies met the inclusion criteria, providing data from 22 countries concerning seven cancer sites. Better symptom knowledge was related to lower odds of a long help-seeking interval in both studies with healthy populations (OR = .73, 95% CI [.63, .84], = 19) and patients (OR = .40, 95% CI [.23, .69], = 12), and so was interpreting experienced symptoms as cancer-related (OR = .52, 95% CI [.36, .75], = 13 studies with patients). More positive beliefs about cancer (i.e., that cancer is treatable) were associated with lower odds of a long help-seeking interval in both studies with healthy populations (OR = .70, 95% CI [.52, .92], = 11) and with patients (OR = .51, 95% CI [.32, .82], = 7). Symptom knowledge, interpretation, and beliefs about cancer are likely to be universal predictors of help-seeking and should be incorporated into theoretical models of patient help-seeking and interventions aiming to reduce delays.
患者在出现癌症症状后寻求帮助的时间是导致癌症诊断延误的最重要因素之一。我们回顾了寻求帮助的时间与三个心理因素之间的关系：症状知识、症状解释和对癌症的信念。47 项研究符合纳入标准，提供了来自 22 个国家的七个癌症部位的数据。在针对健康人群的研究中，更好的症状知识与较长的寻求帮助间隔的可能性较低相关（OR=0.73，95%CI [0.63，0.84]， = 19），与患者的研究结果相似（OR=0.40，95%CI [0.23，0.69]， = 12），将经历的症状解释为与癌症相关的（OR=0.52，95%CI [0.36，0.75]， = 13 项针对患者的研究）。对癌症更积极的信念（即癌症是可治疗的）与较长的寻求帮助间隔的可能性较低相关，无论是在针对健康人群的研究中（OR=0.70，95%CI [0.52，0.92]， = 11）还是在针对患者的研究中（OR=0.51，95%CI [0.32，0.82]， = 7）。症状知识、解释和对癌症的信念可能是普遍预测寻求帮助的因素，应将其纳入患者寻求帮助的理论模型和旨在减少延误的干预措施中。
