Abstract
BACKGROUND: Delayed treatment of cholelithiasis can lead to serious complications, missed optimal intervention windows, and increased treatment complexity, thereby imposing a greater disease burden on patients. Understanding the reasons for delayed healthcare-seeking from the patient’s perspective is therefore essential. This study aimed to explore the multidimensional factors contributing to delayed medical treatment among patients with cholelithiasis—guided by the Health Belief Model (HBM)—to identify potential targets for intervention and provide a theoretical foundation for optimizing care-seeking behaviors. METHODS: From January to June 2025, semi-structured interviews were conducted with patients diagnosed with cholelithiasis in the Hepatobiliary Surgery Department of Shanxi Bethune Hospital, using purposive sampling. Based on predefined inclusion and exclusion criteria, 14 patients who experienced delayed medical care were enrolled. A phenomenological qualitative research design was adopted, and the interview data were analyzed using Colaizzi’s seven-step method to identify, categorize, and refine key themes. RESULTS: Four major themes and thirteen subthemes were identified as factors to delayed medical treatment among patients with cholelithiasis: (1)Illness perception-related barriers (deficient disease-related knowledge, misinterpretation of clinical symptoms, underestimation of symptom severity); (2) Psychological and cognitive barriers in health decision-making (low self-efficacy in health management, risk-avoidant healthcare decision-making, unmet or unrealistic treatment expectations); (3) Healthcare system-level barriers (inadequate access to medical information, suboptimal initial healthcare facility selection, physician–patient communication barriers, and adverse or stressful experiences in healthcare navigation); (4) Social and structural constraints (insufficient family support, conflicts arising from social or other roles, and financial constraints). CONCLUSION: This study identified multiple interrelated barriers contributing to delayed care-seeking among patients with cholelithiasis, spanning illness perception, health decision-making, healthcare navigation, and socio-structural factors. Targeted strategies are needed to enhance patients’ recognition of symptom changes, strengthen confidence in healthcare decision-making, and improve their overall care-seeking experience. Additionally, promoting effective physician-patient communication and reinforcing social support mechanisms may help facilitate more timely engagement with healthcare services. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14033-z.