Understanding patient delay behavior among rural Chinese lung cancer patients: A structural equation modeling...

Patient delay in rural Chinese lung cancer patients often leads to poor prognosis and decreased survival. The aim of this study was to investigate the factors associated with patient delay behavior among rural Chinese lung cancer patients based on the Theory of Planned Behavior.

This was a cross-sectional study of 406 rural lung cancer patients. Measurements included the Patient Activation Measure, Medical Outcomes Study Social Support Survey, Attitudes Toward Medical Help-Seeking Scale, Patient Medical Behavior Intentions Scale, and Sociodemographic and Medical Care Information Questionnaires. The research hypotheses were tested using structural equation modelling. The STROBE checklist was followed.

The patient delay rate for lung cancer patients in rural areas was 43.1 %, and the delay duration was 60 (23, 114) days. Intentions to seek medical care, patient activation and attitudes toward seeking medical care (β = -0.242, -0.233, -0.183, p < 0.05) were directly and negatively associated with patient delay. Patient activation, medical social support and attitudes toward seeking medical care (β = 0.295, 0.358, 0.309, p < 0.001) were directly and positively associated with intentions to seek medical care. Furthermore, intentions mediated the indirect associations between these factors and patient delay.

The findings validate and extend the Theory of Planned Behavior, revealing that higher levels of patient activation, medical social support, attitudes toward seeking medical care, and intentions to seek medical care are directly and indirectly associated with reduced patient delay. Notably, intentions to seek medical care play a key mediating role in reducing this delay.