Fang Jing, Cheng Yuying, Liu Yu, Yang Qing
Department of Nursing, Chengdu Medical College, Chengdu, China.
Department of Bone and Soft Tissue Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
BMC Public Health. 2025 Aug 22;25(1):2881. doi: 10.1186/s12889-025-23783-0.
Cervical cancer is a global health challenge for women, characterized by high morbidity and mortality rates, along with long-term health consequences and economic burden. Early screening and timely treatment can effectively manage cervical cancer, making it crucial for patients to seek medical attention promptly. Positive health-seeking behaviors (HSB) involve the awareness of health issues, self-assessment of health status, and the proactive gathering of information and taking appropriate actions to maintain health. Positive HSB are key to reducing the risk of delayed healthcare access for cervical cancer patients. However, delays in seeking medical care remain prevalent globally.
This study aimed to explore the underlying factors contributing to delayed medical care in cervical cancer patients. The findings provide a basis for improving the timely access to care for these patients.
The study was conducted between July 2024 and October 2024 at a tertiary oncology hospital in China. Cervical cancer patients who experienced delays in seeking medical care were purposively sampled and interviewed. Health-seeking behaviours were collected through semi-structured interviews. Data were analyzed using a theory-driven thematic approach, guided by the Health Belief Model (HBM).
Seventeen cervical cancer patients participated in the study. Four themes emerged: (1) perception and assessment of symptoms (lack of knowledge, benign attribution of symptoms, ignorance of symptoms); (2) perceived threat of the disease (feeling healthy, low susceptibility, no symptomatic threat); (3) perceived benefits and barriers to health-seeking behaviours (reduced disease threat, alleviated psychological and financial burden, low awareness of healthcare access, health insurance coverage, limited healthcare resources); and (4) cues to action (family support, symptom exacerbation). In general, patients with cervical cancer who lack knowledge about the disease and have a diminished perception of the threat of the disease may or may not choose to seek timely medical care after assessing the benefits of health-seeking behaviours and the barriers they face.
This study identifies key barriers to health-seeking behaviours among cervical cancer patients, including limited awareness of early symptoms and underestimated perceptions of risk and severity. It suggests that future interventions should adopt a multifaceted approach targeting healthcare providers, patients, and their social support systems. This strategy should emphasize disease-related knowledge and timely health-seeking behaviours. Clinically, greater emphasis on culturally sensitive communication and patient education is needed to reduce stigma and fear associated with gynecological care. At the policy level, expanding access to affordable screening services and strengthening rural healthcare infrastructure could help reduce disparities and promote earlier diagnosis and treatment.
宫颈癌是一项全球性的女性健康挑战，其特点是发病率和死亡率高，还会带来长期健康后果和经济负担。早期筛查和及时治疗能够有效控制宫颈癌，因此患者及时就医至关重要。积极的求医行为包括对健康问题的认知、对健康状况的自我评估，以及主动收集信息并采取适当行动来维持健康。积极的求医行为是降低宫颈癌患者延迟就医风险的关键。然而，全球范围内延迟就医的情况仍然普遍存在。
本研究旨在探讨导致宫颈癌患者延迟就医的潜在因素。研究结果为改善这些患者及时获得医疗服务提供了依据。
本研究于2024年7月至2024年10月在中国一家三级肿瘤医院进行。对有延迟就医经历的宫颈癌患者进行了有目的抽样和访谈。通过半结构化访谈收集求医行为。数据采用基于理论的主题分析法进行分析，以健康信念模型（HBM）为指导。
17名宫颈癌患者参与了研究。出现了四个主题：（1）症状的感知与评估（知识缺乏、症状的良性归因、对症状的忽视）；（2）对疾病的感知威胁（感觉健康、易感性低、无症状威胁）；（3）求医行为的感知益处和障碍（疾病威胁降低、心理和经济负担减轻、医疗服务获取意识低、医疗保险覆盖、医疗资源有限）；以及（4）行动线索（家庭支持、症状加重）。总体而言，对疾病缺乏了解且对疾病威胁感知降低的宫颈癌患者，在评估求医行为的益处和所面临的障碍后，可能会也可能不会选择及时就医。
本研究确定了宫颈癌患者求医行为的关键障碍，包括对早期症状的认识有限以及对风险和严重程度的低估。研究表明，未来的干预措施应采取多方面的方法，针对医疗服务提供者、患者及其社会支持系统。该策略应强调与疾病相关的知识和及时的求医行为。临床上，需要更加强调具有文化敏感性的沟通和患者教育，以减少与妇科护理相关的耻辱感和恐惧。在政策层面，扩大获得负担得起的筛查服务的机会并加强农村医疗基础设施，有助于减少差距并促进早期诊断和治疗。
