Patient Enablement Linked With Lower Likelihood of Seeking Help for Potential Blood Cancer Symptoms

Patient enablement is associated with a lower likelihood of help seeking for potential blood cancer symptoms, according to the results of a new survey. However, the data did show enablement appears to play an important role in likelihood of reconsulting when symptoms persist, get worse or need further investigation, authors wrote.

Findings were published in Psycho-Oncology.

Health campaigns launched to improve cancer symptom knowledge and encourage prompt help-seeking have shown promise, authors explained. Although campaigns have largely focused on raising awareness of potential cancer symptoms, understanding and addressing wider psychological influences on help-seeking behavior could help bolster efforts to improve awareness, help-seeking, and earlier diagnosis, they added.

To help fill this knowledge gap, the researchers designed and validated a Cancer Awareness Measure to assess public awareness of blood cancer symptoms. Blood cancer specifically, including leukemia, lymphoma, and multiple myeloma, has received less attention than other cancer types in understanding factors that influence the blood cancer diagnostic pathway, the researchers said.

In the current study, they also assessed patient enablement, defined as “the patient's ability to understand and cope with illness and life after a consultation with a doctor.” Those with multimorbidity, individuals with a long-standing health problem, and those in deprived areas reporting higher emotional distress all have lower patient enablement. The study is the first to explore the role of patient enablement on help-seeking for those experiencing potential blood cancer symptoms, the authors noted.

A total of 434 respondents from the United Kingdom completed the survey. All participants were older than age 18, while just over 51% reported experiencing at least 1 blood cancer symptom.

Analyses revealed:

• Half of those experiencing symptoms (112/224) had sought medical help
• Higher scores on patient enablement were associated with being less likely to seek help (odds ratio [OR], 0.89; 95% CI, 0.81-0.98) after controlling for socio-demographics

Higher enablement was associated with being more comfortable to reconsult if symptoms didn't go away or got worse (OR, 1.31; 95% CI, 1.16-1.48); after a test result suggested there was nothing to worry about, but symptoms persisted (OR, 1.23; 95% CI, 1.12-1.34); or to request further tests, scans, or investigations (OR, 1.31; 95% CI, 1.19-1.44)

The most commonly reported symptom was fatigue and the least commonly reported symptom was persistent infections. Mean (SD) participant age was 46 (17.5) years, and 57.7% of symptomatic respondents were female.

Older age was also consistently associated with an increased likelihood of help-seeking for potential symptoms. In addition, those with a long-standing illness were more comfortable to reconsult when symptoms persisted. Individuals with degrees were also more comfortable to reconsult and request further tests, scans, or investigations.

The finding that individuals scoring higher on patient enablement were less likely to seek health when experiencing potential cancer symptoms was contrary to the researchers’ hypothesis. This could be because those who feel more enabled may be more confident to manage their own symptoms for longer before seeking help from a professional.

“Findings demonstrate the added value of exploring wider psychological influences in cancer awareness measures, as well as capturing multiple help-seeking actions, including initial help-seeking and reconsultation behaviors that more accurately reflect the complex diagnostic process,” the authors wrote.

The cross-sectional nature of the study marks a limitation, and the researchers suggest future prospective studies look at the causal relationship between patient enablement and help-seeking to have a more nuanced understanding of the findings’ clinical implications.

“Efforts to optimize the efficacy of public health campaigns to encourage prompt help-seeking by targeting other psychological factors such as enablement will need a deeper understanding of their relationship with help-seeking behaviors to ensure they don't have unintended consequences,” the authors concluded.

Reference

Whitaker KL, Boswell L, Russell J, Black GB, Harris J. The relationship between patient enablement and help-seeking in the context of blood cancer symptoms. Psychooncology. Published online May 18, 2023. doi:10.1002/pon.6170