The University of Southampton
University of Southampton Institutional Repository

Eliciting symptoms interpreted as normal by patients with early-stage lung cancer: could GP elicitation of normalised symptoms reduce delay in diagnosis? Cross-sectional interview study

Eliciting symptoms interpreted as normal by patients with early-stage lung cancer: could GP elicitation of normalised symptoms reduce delay in diagnosis? Cross-sectional interview study
Eliciting symptoms interpreted as normal by patients with early-stage lung cancer: could GP elicitation of normalised symptoms reduce delay in diagnosis? Cross-sectional interview study
Objectives: To investigate why symptoms indicative of early-stage lung cancer (LC) were not presented to general practitioners (GPs) and how early symptoms might be better elicited within primary care.

Design, setting and participants: A qualitative cross-sectional interview study about symptoms and help-seeking in 20 patients from three south England counties, awaiting resection of LC (suspected or histologically confirmed). Analysis drew on principles of discourse analysis and constant comparison to identify processes involved in interpretation and communication about symptoms, and explain nonpresentation.

Results: Most participants experienced health changes possibly indicative of LC which had not been presented during GP consultations. Symptoms that were episodic, or potentially caused by ageing or lifestyle, were frequently not presented to GPs. In interviews, open questions about health changes/symptoms in general did not elicit these symptoms; they only emerged in response to closed questions detailing specific changes in health. Questions using disease-related labels, for example, pain or breathlessness, were less likely to elicit symptoms than questions that used non-disease terminology, such as aches, discomfort or ‘getting out of breath’. Most participants described themselves as feeling well and were reluctant to associate potentially explained, nonspecific or episodic symptoms with LC, even after diagnosis.

Conclusions: Patients with early LC are unlikely to present symptoms possibly indicative of LC that they associate with normal processes, when attending primary care before diagnosis. Faced with patients at high LC risk, GPs will need to actively elicit potential LC symptoms not presented by the patient. Closed questions using non-disease terminology might better elicit normalised symptoms.
e001977-[12pp]
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Corner, Jessica
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Banerjee, Anindo
cbbef68b-3cef-42b2-86a4-2f94df3f1288
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Brindle, Lucy
17158264-2a99-4786-afc0-30990240436c
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Corner, Jessica
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Banerjee, Anindo
cbbef68b-3cef-42b2-86a4-2f94df3f1288
Leydon, Geraldine M.
c5cdaff5-0fa1-4d38-b575-b97c2892ec40

Brindle, Lucy, Pope, Catherine, Corner, Jessica, Banerjee, Anindo and Leydon, Geraldine M. (2012) Eliciting symptoms interpreted as normal by patients with early-stage lung cancer: could GP elicitation of normalised symptoms reduce delay in diagnosis? Cross-sectional interview study BMJ Open, 2, (6), e001977-[12pp]. (doi:10.1136/bmjopen-2012-001977). (PMID:23166137).

Record type: Article

Abstract

Objectives: To investigate why symptoms indicative of early-stage lung cancer (LC) were not presented to general practitioners (GPs) and how early symptoms might be better elicited within primary care.

Design, setting and participants: A qualitative cross-sectional interview study about symptoms and help-seeking in 20 patients from three south England counties, awaiting resection of LC (suspected or histologically confirmed). Analysis drew on principles of discourse analysis and constant comparison to identify processes involved in interpretation and communication about symptoms, and explain nonpresentation.

Results: Most participants experienced health changes possibly indicative of LC which had not been presented during GP consultations. Symptoms that were episodic, or potentially caused by ageing or lifestyle, were frequently not presented to GPs. In interviews, open questions about health changes/symptoms in general did not elicit these symptoms; they only emerged in response to closed questions detailing specific changes in health. Questions using disease-related labels, for example, pain or breathlessness, were less likely to elicit symptoms than questions that used non-disease terminology, such as aches, discomfort or ‘getting out of breath’. Most participants described themselves as feeling well and were reluctant to associate potentially explained, nonspecific or episodic symptoms with LC, even after diagnosis.

Conclusions: Patients with early LC are unlikely to present symptoms possibly indicative of LC that they associate with normal processes, when attending primary care before diagnosis. Faced with patients at high LC risk, GPs will need to actively elicit potential LC symptoms not presented by the patient. Closed questions using non-disease terminology might better elicit normalised symptoms.

Full text not available from this repository.

More information

Published date: 19 November 2012
Organisations: Faculty of Health Sciences, Primary Care & Population Sciences

Identifiers

Local EPrints ID: 346264
URI: http://eprints.soton.ac.uk/id/eprint/346264
PURE UUID: c40d5579-927c-4cd9-83c8-215f320ec895
ORCID for Lucy Brindle: ORCID iD orcid.org/0000-0002-8933-3754
ORCID for Catherine Pope: ORCID iD orcid.org/0000-0002-8935-6702

Catalogue record

Date deposited: 14 Dec 2012 16:35
Last modified: 18 Jul 2017 05:04

Export record

Altmetrics

Contributors

Author: Lucy Brindle ORCID iD
Author: Catherine Pope ORCID iD
Author: Jessica Corner
Author: Anindo Banerjee

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×