Delay In Seeking Medical Evaluation For Suspicious Breast Symptom(s) Among Taiwanese Women in Taiwan

YI-CHING LI University of Illinois at Chicago, 2012 Chair and Advisor: Carol Ferrans ABSTRACT Purpose: The purpose of this study was to explore factors that contribute to delay in seeking medical evaluation for suspicious breast cancer symptoms among Taiwanese women. Rationale/Significance of Study: Because there are still no effective breast cancer prevention methods, improving breast cancer early detection is thus critically important. To achieve this goal, we need to understand the culturally-specific factors that cause Taiwanese women to delay. Method: A descriptive, cross-sectional study guided by an adapted version of a conceptual framework originally developed by Pikkasame and Ferrans in 2004 was applied in this study. Participants were interviewed by an interview guide (including multiple instruments and open-ended questions). Negative binomial regression analyses was used to access predictors for patient delay. Main Research Variables: Patient delay is the dependent (outcome) variable in this study. Independent variables include cognitive response (perceived seriousness of breast symptoms), affective response (anxiety and fear), individual factors (demographic characteristics, cultural beliefs about breast cancer, clinical factors of breast symptoms, and quality of life), social factors (role demands and the influence of others), and health care factors (access to health care, health utilization habits, and trust in physician). Participants: A total number of 149 women with suspicious breast symptoms participated in this study and completed the interviews in a medical center in Taipei, a city in the northern part of Taiwan. Results: Approximately one-third of Taiwanese women (32.9%) delayed for greater than three months in this study. The results showed that Taiwanese women who have breast symptoms without pain, perceive lower seriousness of breast symptoms, have lower health utilization habits, and had fewer people encouraging them to have their symptoms evaluated, were more likely to have longer patient delay. Conclusion: This study provides insights into reasons for delay when a woman discovers suspicious breast symptoms in Taiwan. The findings of this study can be used to help women to better understand the symptoms of breast cancer and the importance of early detection of suspicious symptoms. (Total of 325 words)