Primary Health Care Center Riu Nord i Riu Sud, Catalan Health Institut, Barcelona, Spain.
Research Support Unit Metropolitana Nord, University Institute for Primary Health Care Research (IDIAP) Jordi Gol, Catalan Health Institute, Barcelona, Spain.
Health Expect. 2023 Feb;26(1):476-487. doi: 10.1111/hex.13681. Epub 2022 Nov 29.
Early detection of symptoms and prompt diagnosis of ovarian cancer are considered important avenues for improving patient experiences and outcomes.
This qualitative study used a phenomenological approach to perform patient interviews, collecting individual accounts of the prediagnostic phase in women diagnosed and treated for ovarian cancer in 2016-2017. Purposive sampling was used to obtain a diverse sample of 24 participants, while thematic content analysis was used to extract themes and subthemes from interview data.
Three themes and nine subthemes were identified. The first theme was women's delay in recognizing symptoms and seeking care, with subthemes on the lack of knowledge about early signs of ovarian cancer, gender-related barriers and false reassurance from negative test results. A second theme was missed opportunities during healthcare encounters, due to misattribution of women's symptoms by their physicians, underestimation of symptom severity and need for mediation and inadequate tests and/or false negative results. Finally, interviews highlighted the use of resources and alternative healthcare pathways, including complementary/alternative medicines, access to private health care and women's capacity for action and decision-making (agency) about their health.
Delayed diagnosis of ovarian cancer is rooted in both individual factors (lack of health literacy, reluctance to seek care) and systemic issues (missed opportunities in healthcare encounters, access to timely specialist care). Further research is needed to investigate the extent to which traditional gender roles and socioeconomic inequalities condition women's ability to manage their own health and to interact with health professionals and the health system.
In addition to the patient participation during the interviews, one author was a representative of a patient association.
早期发现症状和及时诊断卵巢癌被认为是改善患者体验和预后的重要途径。
本研究采用现象学方法对 2016 年至 2017 年间被诊断和治疗卵巢癌的女性进行患者访谈，收集个体在诊断前阶段的情况。采用目的抽样法获得 24 名参与者的多样化样本，同时采用主题内容分析法从访谈数据中提取主题和子主题。
确定了三个主题和九个子主题。第一个主题是女性对症状的认识和寻求治疗的延迟，包括对卵巢癌早期迹象缺乏了解、性别相关障碍和阴性测试结果的虚假保证等子主题。第二个主题是医疗保健接触中错失的机会，由于医生对女性症状的归因错误、对症状严重程度和需要调解的低估以及测试不足和/或假阴性结果。最后，访谈强调了资源和替代医疗途径的利用，包括补充/替代药物、获得私人医疗保健以及女性对自身健康的行动和决策能力（能动性）。
卵巢癌的诊断延迟既源于个体因素（健康素养不足、不愿寻求治疗），也源于系统问题（医疗保健接触中错失机会、及时获得专科治疗的机会有限）。需要进一步研究传统性别角色和社会经济不平等如何影响女性管理自身健康以及与卫生专业人员和卫生系统互动的能力。
除了患者在访谈中的参与，一位作者是患者协会的代表。
