Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study

Abstract

Background Lung cancer is the leading cause of cancer incidence and mortality worldwide. Prompt patient help-seeking for signs and symptoms suggestive of lung cancer is crucial for early referral, diagnosis, and survivorship. However, individuals with potential lung cancer symptoms tend to delay help-seeking. This qualitative study explored perceived barriers to patient help-seeking and strategies to enhance help-seeking for lung cancer warning signs and symptoms from the perspective of primary healthcare professionals. Methods Semi-structured focus groups and individual interviews were conducted with 36 primary healthcare professionals. Data were collected via videoconferencing. Inductive thematic analysis was conducted. Results The following two themes were created from the data: (i) perceived barriers to patient help-seeking for signs and symptoms of concern and (ii) facilitating early patient presentation for signs and symptoms of concern. Some participants believed that the high cost of a general practitioner visit, long waiting times, and previous bad experiences with the healthcare system would deter patients from seeking help for symptoms of lung cancer. Perceived patient-related barriers to help-seeking related to the different emotions associated with a potential cancer diagnosis as well as stigma, embarrassment, and guilt felt by smokers. Sociodemographic factors such as drug use, homelessness, living in rural areas, and being male and older were also perceived to impede patient help-seeking. The negative impact of the COVID-19 pandemic on cancer help-seeking also featured strongly. Participants recommended several strategies to enable patients to seek help for symptoms of concern including targeted educational campaigns focussing on symptoms (e.g., cough) rather than behaviours (e.g., smoking), accessible and free health services, and using patients’ support networks. Conclusions Patient-related and healthcare system-related barriers to help-seeking for lung cancer warning signs and symptoms include cost of healthcare, cancer fear, and various sociodemographic factors. Participants suggested that increased awareness and early patient help-seeking for symptoms of concern could be achieved through targeted patient education, national campaigns, the use of community support networks, and free and accessible targeted screening services.

A systematic review of interventions to recognise, refer and diagnose patients with lung cancer symptoms

“…Participants who decided not to consult their GP cited concerns over wasting their own and the GP time and reported a high symptom tolerance threshold and a greater tendency to self-manage their symptoms 42 . These barriers are well documented in the wider literature 15 , 16 , 18 .…”

“…However, a Swedish study found that patients diagnosed with LC experience, on average, a 6-month delay between symptom onset and initiation of treatment 13 . Reasons for delayed patient help-seeking include patient factors, such as symptom misappraisal, fear of a potential cancer diagnosis, and guilt associated with smoking 14 , 15 , as well as healthcare system factors, such as the high financial cost of healthcare, lack of access to healthcare, and previous bad experiences with the healthcare system 15 – 18 .…”

“…Primary healthcare professionals (HCPs) play a key role in facilitating early diagnosis through recognising people with signs and symptoms suggestive of LC and referring them appropriately 19 . HCP-related barriers to early diagnosis of LC may include lack of awareness of signs and symptoms of LC, inadequate access to diagnostics and rapid referral pathways, and fear of overburdening the healthcare system 15 , 18 . In this systematic review, we identify and describe the effect of interventions aimed at helping HCPs recognise and refer individuals with signs and symptoms indicative of LC to the appropriate healthcare pathway in a timely manner.…”

Therapeutic concordance improves blood pressure control in patients with resistant hypertension

“…A qualitative study conducted by Weiss and colleagues [ 49 ] examined the implementation of decision analysis to facilitate the involvement of patients in decisions about their healthcare, and reported that only a few newly diagnosed hypertensive patients felt they were able to discuss issues with their doctor, and that most felt the physician did not have enough time. Barriers in consultations and decision-making have been reported by both physicians and patients [ 50 , 51 ], albeit more recent findings suggest that health professionals should be aware of the potential impact of patients’ feelings of guilt on consultations relating to the asymptomatic disease of hypertension [ 52 , 53 ].…”

Telehealth in the context of COVID-19: An Analysis of Men’s Usage and Perceptions in Comparison to In-Person Healthcare

“…8 While emergent studies during the pandemic have reported high levels of patient satisfaction 9 with telehealth comparable to in-person appointments, males reported poorer experiences with telehealth than females. 10 Though some healthcare professionals have expressed concerns about misdiagnosing without in-person contact, 11 patients cite improved outcomes, increased accessibility, convenience, and decreased costs as reasons for their satisfaction with telehealth services. 12,13 Given these, telehealth may have the potential to engage men by reducing or addressing many of the aforementioned barriers men experience when accessing in-person health services.…”