Behavioural trajectories of delay in seeking medical care in participants with breast cancer-related lymphoedema: a qualitative study

乳腺癌相关淋巴水肿患者就医延迟行为轨迹:一项定性研究

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Abstract

OBJECTIVES: This qualitative study aimed to address the following central research question: what are the key factors and behavioural trajectories influencing delayed medical care-seeking among participants with breast cancer-related lymphoedema (BCRL), and how do these factors operate across the stages of symptom perception, alertness and decision-making? DESIGN: This qualitative study employed a phenomenological approach, with semistructured interviews conducted to explore participants' experiences. SETTING: A tertiary hospital located in North China. PARTICIPANTS: 18 patients with BCRL were recruited through purposive maximum variation sampling and interviewed in person between January and June 2023. RESULTS: 10 themes emerged and were categorised into three stages: (1) the perception stage (lack of disease knowledge, risk underestimation and symptom avoidance); (2) the alertness stage (failed self-management, negative coping and exposure to misinformation) and (3) the decision-making stage (financial burden, limited healthcare access, insufficient social support and fatalism). The average delay was 10.2 months, with prolonged delays (>12 months) linked to severe lymphoedema progression. CONCLUSION: Delayed care seeking in BCRL is a multifactorial behavioural trajectory shaped by knowledge gaps, systemic barriers and psychosocial factors. Clinicians should prioritise early patient education and context-sensitive interventions to mitigate delays.

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