Behavioural trajectories of delay in seeking medical care in participants with breast cancer-related lymphoedema: a qualitative study.

Abstract

This qualitative study aimed to address the following central research question: what are the key factors and behavioural trajectories influencing delayed medical care-seeking among participants with breast cancer-related lymphoedema (BCRL), and how do these factors operate across the stages of symptom perception, alertness and decision-making? This qualitative study employed a phenomenological approach, with semistructured interviews conducted to explore participants' experiences. A tertiary hospital located in North China. 18 patients with BCRL were recruited through purposive maximum variation sampling and interviewed in person between January and June 2023. 10 themes emerged and were categorised into three stages: (1) the perception stage (lack of disease knowledge, risk underestimation and symptom avoidance); (2) the alertness stage (failed self-management, negative coping and exposure to misinformation) and (3) the decision-making stage (financial burden, limited healthcare access, insufficient social support and fatalism). The average delay was 10.2 months, with prolonged delays (>12 months) linked to severe lymphoedema progression. Delayed care seeking in BCRL is a multifactorial behavioural trajectory shaped by knowledge gaps, systemic barriers and psychosocial factors. Clinicians should prioritise early patient education and context-sensitive interventions to mitigate delays.