Study On The Patient Delay Among Gastric Cancer Patients And Its Influence Factors In Yanan Province

Objective:To understand gastric cancer patients’perceptions of gastric cancer-related symptoms and the occurrence of medical treatment delay at the first visit;to investigate the correlation between the occurrence of medical treatment delay at the first visit of gastric cancer patients and medical social support level and coping style;to analyze the factors influencing the occurrence of medical treatment delay at the first visit of gastric cancer patients based on the treatment pathway model,and to clarify the influence of medical social support level and coping style on the occurrence of medical treatment delay at the first visit of gastric cancer patients The impact of medical social support level and coping style on the delay of gastric cancer patients in their first consultation was clarified.To provide a theoretical basis for reducing the delay in seeking medical treatment and improving the survival rate and quality of survival of gastric cancer patients.Methods:A convenience sampling method was used to select patients with gastric cancer who visited the Department of Gastrointestinal Surgery,Department of Oncology and Department of Gastroenterology of Yan’an University Hospital and Yan’an People’s Hospital from 2021.12 to 2022.12 according to the nadir criteria as the study population,and a questionnaire survey was conducted,and the survey instruments were divided into a questionnaire for gastric cancer patients,Medical Social Support Scale(MOS-SSS-C),Coping Style Questionnaire(MCMQ)in three parts.Excel was used to establish a database for data entry,and IBM SPSS Statistics 27.0 software was used for statistical analysis of the data.The mean±standard deviation,median and quartiles were used to describe the measurement data,and the frequency and composition ratio were used to describe the count data;Pearson and Spearman were used to analyze the correlation between the delay in seeking medical treatment and the level of medical social support and coping style of gastric cancer patients;chi-square test,two independent samples t-test,Mann-Whitney U test,and multi-factor logistic regression analysis to explore the factors influencing the delay in medical care for gastric cancer patients.Results:1.62.3%of 252 gastric cancer patients did not know the symptoms related to gastric cancer;75.0%did not know the risk factors of gastric cancer;73.8%did not know that early detection,diagnosis and treatment could help the prognosis of gastric cancer;90.5%did not know about cancer screening.93.3%of 252 gastric cancer patients found out gastric cancer by feeling serious symptoms and going to hospital to find out,59.5%The first hospital for gastric cancer patients was a municipal hospital,and 59.9%of gastric cancer patients chose the first hospital because of its good reputation.169 of 252gastric cancer patients had delayed access to medical treatment,and the delay rate was67.1%.2.Correlation analysis showed that practical support(r=-0.169,P<0.01),social interaction support(r=-0.314,P<0.01)and total medical social support score(r=-0.151,P<0.01)were negatively associated with the occurrence of delayed access to care;confrontation dimension(r_s=-0.139,P<0.05)of coping style was negatively associated with the occurrence of delayed access to care,avoidance dimension(r_s=0.176,P<0.01)and submission dimension(r_s=0.200,P<0.01)were positively associated with the occurrence of delayed access to care.3.Univariate analysis revealed statistically significant differences(P<0.05)in the effects of household type,education level,occupation,monthly per capita household income,TNM stage,whether metastasis occurred,previous history of gastric cancer,gastric cancer symptom perception,practical support dimension,social interactive support dimension,total medical social support score,confrontation dimension,avoidance dimension and submission dimension on delay in seeking medical treatment for gastric cancer patients.Multi-factor logistic regression analysis showed that household type,education level,per capita household income,perception of gastric cancer symptoms and the submission dimension of coping style were influential factors in the delay in seeking medical treatment for gastric cancer patients.Conclusions:1.more than half of gastric cancer patients had inadequate awareness of gastric cancer-related symptoms and delay in seeking medical treatment.2.Whether patients with gastric cancer experienced delay in seeking medical treatment was negatively correlated with the actuality support,social interaction support,and total medical social support score of medical social support level.Whether patients with gastric cancer experienced delayed access to medical care was negatively correlated with the confrontation dimension of coping style and positively correlated with the avoidance and submission dimensions.3.Household type,education level,per capita household income and perception of gastric cancer symptoms were protective factors for delay in seeking medical treatment for gastric cancer patients.The yielding dimension of coping style was a risk factor for delay in seeking medical treatment for patients with gastric cancer.