Oviasu Osaretin, Coleby Dawn, Padley Wendy, Panchal Rakesh K, Hinsliff-Smith Kathryn
Faculty of Health and Life Sciences, Leicester School of Nursing & Midwifery, De Montfort University (DMU), Leicester, LE1 9BH, United Kingdom.
Faculty of Health and Life Sciences, Leicester School of Nursing & Midwifery, De Montfort University (DMU), Leicester, LE1 9BH, United Kingdom.
Eur J Oncol Nurs. 2025 Aug;77:102927. doi: 10.1016/j.ejon.2025.102927. Epub 2025 Jul 9.
Prognosis with pleural mesothelioma (PM) is poor, yet evidence indicates a better chance of survival and quality of life if diagnosed earlier. There has been little attention to PM patients' experiences prior to diagnosis as available studies have focused on their lived experiences after diagnosis. This study aims to qualitatively explore and identify the barriers and facilitators to PM diagnosis and looks to understand the reasons for any variability in patients' experiences along their diagnosis journey and proposed treatment plans.
Seventeen participants with confirmed PM diagnosis took part in in-depth, semi-structured interviews about their journey to diagnosis. Participants were purposively recruited from two specialist PM outpatient clinics in England. The interview data were analysed using framework analysis underpinned by the Model of Pathway to treatment.
Our findings identified 15 different barriers and facilitators across the four intervals within the model. Within the appraisal and diagnostic intervals, the presentation of vague symptoms that were mistaken for a less serious illness were a considerable barrier. Health literacy regarding PM had an impact on how soon a patient sought help regarding their symptoms and how quickly they were placed on a PM diagnostic pathway by the healthcare professionals (HCP), and this was impacted the HCP's knowledge of PM.
Earlier symptom recognition by both patient and those in initial contact such as General practitioners (GPs) and other HCPs, can be used to target significant and avoidable delays along the pathway, thereby promoting earlier diagnosis and treatment options.
胸膜间皮瘤（PM）的预后较差，但有证据表明，如果能早期诊断，患者生存和生活质量改善的机会更大。此前很少有人关注PM患者在诊断之前的经历，因为现有研究主要集中在他们确诊后的生活经历。本研究旨在定性探索并确定PM诊断的障碍和促进因素，了解患者在诊断过程和拟议治疗方案中经历存在差异的原因。
17名确诊为PM的参与者参加了关于其诊断过程的深入半结构化访谈。参与者是从英国的两家PM专科门诊诊所中特意招募的。访谈数据采用基于治疗路径模型的框架分析法进行分析。
我们的研究结果在该模型的四个阶段中确定了15种不同的障碍和促进因素。在评估和诊断阶段，模糊症状被误诊为不太严重疾病是一个相当大的障碍。关于PM的健康素养影响患者就其症状寻求帮助的时间，以及医疗保健专业人员（HCP）将他们纳入PM诊断路径的速度，这又受到HCP对PM了解程度的影响。
患者以及如全科医生（GP）和其他HCP等最初接触者更早地识别症状，可用于解决该过程中重大且可避免的延误问题，从而促进早期诊断和治疗选择。
