Influencing Factors Of Delays In Treatment-seeking Among Esophageal Cancer Patients

Objectives:1. To investigate the current status of delays in treatment-seeking among esophageal cancer patients.2. To analyze the influencing factors of delays in treatment-seeking among esophageal cancer patients based on the Health Ecological Model.Methods:From July 2014 to January 2015,345 patients with esophageal cancer were recuited using purpose sampling method from 4 hospitals (2 Grade-Ⅲ Level-A hospitals and 2 Grade-II Level-A hospitals) in Jinan city. This is a cross-sectional study, based on the Health Ecological model, adopted the self-designed questionnaires of the general data, medical-seeking situation, health literacy, health hardiness and social support to investigate the current situation and influencing factors of delays in treatment-seeking among esophageal cancer patients, and to analyze the relationship between the influencing factors. Descriptive statistics were used to describe the survey data of esophageal cancer patients, and univariate analysis and Logistic regression analysis were conducted to select the influencing factors of delays in treatment-seeking among esophageal cancer patients. All statistical analyses were performed using SPSS 17.0 software. Statistical significance was accepted at the P< 0.05 level.Results:1. The shortest time of patients found the related symptoms to have a treatment was 0.5 days, the longest time was 730 days, and the median time was 40 days.2. The treatment-seeking delay rate was 33.75% among esophageal cancer patients. The proportion of 90 days to 180 days was 22.5%(72 cases),180 days to 360 days was 7.5%(24 cases), and more than 360 days was 3.75%(12 cases).3. Univariate analysis showed that gender, age, chronic diseases, smoking, drinking, health values, external control sexual health value, account type, objective and subjective support, utilization of support, families whether or not engaged in medical and health work, family per capita monthly income, level of education were the associated factors of patient delay.4. Multivariate analysis showed that gender, age, chronic diseases, smoking, drinking, health values, external control sexual health value, account type, objective and subjective support, utilization of support, the family whether or engaged in medical and health work, and family per capita monthly income were the associated factors of treatment-seeking delay among esophageal cancer patients.Conclusions:1. The treatment-seeking delay of esophageal cancer is comparatively common, 33.75% of patients delayed more than 3 months.2. The main factors affecting the delay of medical treatment of esophageal cancer patients were:age, gender, whether associated with chronic disease, smoking, drinking, health values, external control sexual health value, account type, social support, whether the family engaged in medical and health work and family per capita monthly income.3. Based on the Health Ecology Model, influencing factors of treatment-seeking delay were:the upstream factors (macroscopic) affected the delayed behavior of patients are:whether the family engaged in medical and health work, account type, family per capita monthly income; midstream factors (intermediaries) are:smoking, drinking, healthy values, external control sexual health value, objective and subjective support, utilization of support; downstream factors (microscopic) are:sex, age, chronic diseases.