Medical help-seeking for symptoms of breast cancer in obese, overweight, and healthy weight populations

  • Catherine Elizabeth Grimley

    Student thesis: Doctoral ThesisDoctor of Philosophy


    One in eight women will receive a diagnosis of breast cancer in their lifetime. Early detection and diagnosis is linked with a better prognosis, yet a significant proportion of women take three months or more to present to the GP with symptoms. Obesity is an important risk factor for breast cancer and research in closely related areas suggest there are associations between obesity and avoidance of healthcare. However, there is little research within help-seeking of the potential association with obesity and other health factors.

    The main thesis aims were to: determine factors which predict help-seeking behaviour in women with potential symptoms of breast cancer and to determine whether these factors are affected by BMI using quantitative methods; to explore the health beliefs and attitudes of women in different weight categories (obese, overweight, and normal weight) using qualitative methods; and to statistically map the help-seeking factors and relationships between the factors to formulate a help-seeking model using Structural Equation modelling. These aims were met with a mixed methods design, incorporating both quantitative and qualitative methodologies, used together in order to enhance the overall findings. Finally, the structural equation model was built using the findings from both the quantitative and qualitative studies.

    BMI was associated with shorter help-seeking times in those who sought help within a month. Higher self-efficacy and a perception of a shorter duration of symptoms were associated with a shorter time to presentation in the healthy weight group, whereas higher response-efficacy, higher emotional illness representations and lower level of anxiety were associated with a shorter time to presentation in the overweight and obese group. This research also found that a previous referral affected how women thought about future help-seeking. Positive previous experiences, instruction and advice are vitally important at the breast referral appointment to maintain confidence for any subsequent help-seeking, which is essential due to the number of women in the study with a previous breast referral. The Extended Parallel Processing Model (EPPM) was used as the basis for a model used to predict time to presentation. Utilisation of the EPPM in help-seeking research is novel and showed that it might be a useful tool for further study of help-seeking behaviour and the development of a future intervention to promote more prompt help-seeking.
    Date of AwardJun 2020
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorBeth Grunfeld (Supervisor) & Elizabeth Bailey (Supervisor)

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