HLT 302 Topic 4 Discussion Question One
HLT 302 Topic 4 Discussion Question One
What is your earliest memory of being sick? Similarly, what is your first memory of some sort of medical care? Was it positive? Looking back on it from the vantage point of your current knowledge and experience, was your care back then good and adequate?
People often avoid seeking medical care even when they suspect it may be necessary;1–4 nearly one-third of respondents in a recent national United States (U.S.) survey reported avoiding the doctor.5–7 Even individuals with major health problems4,8,9 or who are
experiencing symptoms10–12 avoid seeking medical care. For example, in one study, 17% of patients diagnosed with rectal tumors reported that they waited a year or more to seek medical consultation after noticing symptoms, with some waiting up to five years.12 Avoiding medical care may result in late detection of disease, reduced survival, and potentially preventable human suffering.
In the present study, we sought to understand why people avoid seeking medical care. Avoidance of medical care has been defined as “keeping away from something [in a medical context] that is thought to cause mental or physical distress.”8 Avoidance can also occur as a result of barriers, which can be defined as factors that limit access to or ease of obtaining quality health care (e.g., financial concerns, time constraints).1,15 Avoidance of medical care can occur at any point on the disease continuum, including preventing and detecting asymptomatic disease, noticing symptoms and interpreting their significance, seeking care after determining a potential need, and complying with recommended treatment.1,2,16 Of note, the term “patient delay” has also been used to describe phenomena related to avoidance, but guidelines for research on early cancer diagnosis have suggested instead using the more informative terms “appraisal interval” (the time taken to interpret symptoms) and “help-seeking interval” (the time taken to seek care after determining a need).17
To date, research on avoidance of medical care has been limited in the extent to which it examines the broad spectrum of reasons for avoidance (but see 7), often focusing on specific factors such as barriers or psychological characteristics (e.g., lack of insurance, fear of a diagnosis).4–6,15,18–24 A conceptual review of reasons people avoid medical care identified only six qualitative or mixed-methods studies assessing participant-generated reasons, all of which used convenience samples with predominately white participants.1 Moreover, five of the six studies reviewed assessed avoidance of specific procedures.1 The exception was a focus group study among a sample of Hispanics that explored reasons for avoiding medical visits in response to warning signs of heart disease, cancer, and diabetes.11 This qualitative study identified factors such as low trust in doctors, low perceived severity of symptoms, emotional factors (e.g., denial, avoiding worry, embarrassment), practical barriers, and prior negative experiences as contributing to avoidance.