Patients’ decision making in seeking care for suspected malignant melanoma

Abstract

hajdarevic s , hörnsten a, sundbom e, brulin c, schmitt‐egenolf m (2010) Journal of Nursing and Healthcare of Chronic Illness 2 , 164–173 Patients’ decision making in seeking care for suspected malignant melanoma Aim. To explore patients’ decision making about seeking care for malignant melanoma (MM). Background. Unlike other cancers, MM is generally visible and can be easily and cheaply cured if treated in time. It is the delay in diagnosis, most often attributable to the patient rather than to care providers, that results in mortality. Self‐examination of suspicious lesions is important, but it is not a guarantee of immediate care‐seeking, nor is early detection and increased melanoma awareness associated with early care‐seeking. Method. During 2009, men ( n = 10) and women ( n = 11) diagnosed with malignant melanoma were interviewed within two years after excision and the text was analysed according to Grounded Theory. Results. The perception of a critical level of severity, feelings of fear and threat were found to be a key motivator for patients to seek care for suspected melanomas; as soon as sufficient insight into the severity of the disease was achieved, the patient reached a turning point and sought care immediately. Conclusions. Most of the participants described the process from the discovery of the lesion to the decision to seek care as a time‐consuming inner negotiation about the severity of the disease, personal and social considerations, and interactions with the healthcare system. Relevance to clinical practice. We analysed the complex reasoning of the patients leading up to the turning point when they sought care. This study illustrates for caregivers the importance of simplifying the pathways to care, emphasising the seriousness of MM, and taking worried patients seriously from their first contact with health care. Health professionals, through their attitudes in contact with patients, can either facilitate or obstruct the patient’s decision making process.