Responding to symptoms suggestive of XXXX : a qualitative interview study.

@entity1 @entity2
BACKGROUND: Late diagnosis of @entity2 can impact on survival rates. @entity1 delay seeking help for a number of reasons. This study explored symptom appraisal and help-seeking decisions among @entity1 referred to specialist respiratory services with symptoms suggestive of @entity2 . METHODS: In-depth qualitative interviews with @entity1 as soon as possible after referral, ideally before diagnosis and mainly within 10   weeks, explored factors impacting on their pathways prior to referral. Framework analysis, underpinned by the Model of Pathways to Treatment, was used to explore the data with particular focus on @entity1 ' beliefs and experiences, disease factors and healthcare professional influences. RESULTS: 35 @entity1 were interviewed (aged 41-88   years, 15 @entity1 , 17 with @entity2 ). All described similar presenting symptoms and triggers to seek help. Appraisal of symptoms was influenced by whether they had a lung comorbidity; seriousness of symptoms was interpreted within the context of previous illness experiences. Help-seeking was triggered when: symptoms failed to respond as expected; there was an increased awareness of symptoms of @entity2 ; the public nature of a cough meant others were able to endorse help-seeking. Almost half visited the general practitioner (GP) two or more times before referral; during this period they reinterpreted initial symptoms and appraised new symptoms. The meaning given to symptoms changed over time and many became increasingly concerned they may have @entity2 . The GP played a role in ensuring timely further help-seeking but often there was little guidance on how to monitor symptoms or when to reconsult. CONCLUSIONS: @entity1 diagnosed with and without @entity2 had similar symptom pathways. Findings provide guidance for @entity2 awareness campaigns on the importance of social networks in endorsing @entity1 help-seeking. The importance of appropriate advice, monitoring and safety-netting procedures by GPs for @entity1 presenting with symptoms suggestive of @entity2 is also highlighted.
