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Background: The psychological processes involved in the delay between noticing breast symptoms and seeking medical care are not well understood.Methods: We evaluated 85 women referred to a specialist breast clinic prior to their clinic appointment. We assessed the relationship between delay and the type of breast symptom, immediate emotional response to the symptom, perceived risk of breast cancer, fear of breast cancer treatment, and disclosure of the breast symptom to others.Results: Delay was unrelated to demographic factors but was related to the type of breast symptom; women who had a breast lump waited a significantly shorter time period before visiting the doctor than those without a breast lump. Initial symptom distress on the discovery of the breast symptom was also significantly related to delay. Knowledge of a friend or family member with breast cancer, perceived risk of breast cancer and fear of breast cancer treatment, and disclosure of the symptom to a partner or other person were all unrelated to delay.Conclusions: The results show the importance of the type of symptom and initial emotional distress in delay and highlight the importance of widening public perceptions of breast symptoms other than breast lumps in order to reduce delay times. [ABSTRACT FROM AUTHOR]

Objective: To examine patients' expectations of their first outpatient visit to a pain clinic. We asked patients what would be the most satisfying and the most disappointing outcomes of their visit and whether they expected changes in medication and further investigations to result from their consultation., Design: Patients completed questionnaires and a structured interview to assess expectations before their clinic appointment., Methods: Seventy-seven patients with chronic pain who were first time referrals to a regional pain clinic participated in the study. Patient expectations and questionnaires measuring depression and pain-related disability were completed prior to the pain clinic appointment., Results: Most patients expected an explanation or an improved understanding of their pain problem. The most common satisfying outcome was relief or control of pain, and the most common disappointing outcome was being told nothing could be done. The majority of patients expected further medical investigations and changes to the prescribed medication. Depression and pain-related disability strongly influenced patient expectations., Conclusions: For patients attending pain clinics, the explanation of their pain problem is rated as important as the cure or relief of their pain. Improved understanding of patient expectations by pain clinic clinicians may lead to greater patient satisfaction and reduced treatment dropout.

Aims: To investigate the extent of patient delay in new patients with self-detected breast symptoms referred to a specialist breast clinic. To examine the association between delay and sociodemographic factors, the practice of breast self-examination (BSE), how the breast symptom was discovered, and personal experience of breast cancer in family and friends., Methods: Eighty five women referred to the South Auckland Health Breast Clinic completed a questionnaire and interview after arrival at the clinic and prior to their consultation with the medical specialist. Delay was measured as the time interval between initial self-detection of a breast symptom and first contact with a general practitioner (GP) for evaluation of the symptom. Analysis of patient characteristics and delay time was conducted using Pearson product moment correlations, t-test for independent samples and one way analysis of variance (ANOVA) where appropriate., Results: The median delay time between initial breast symptom detection and seeing a GP was 14 days. Of the total sample of 85 women, 40% had seen their doctor within 7 days, 52% within 14 days, 69% within 30 days, and 14% had waited over 90 days. Delay time was not significantly associated with any sociodemographic factors. No difference in delay time was found between the ethnic groups of European, Maori or Pacific women. No difference in delay was shown between those women who performed regular BSE and those who did not. However, women who discovered their breast symptom by chance or through BSE had a shorter delay time than women experiencing breast pain. Although experience of a friend or family member with breast cancer was not significantly associated with delay, there was a trend for women who had a family member with breast cancer to have a longer delay time before seeing their GP., Conclusions: This study is the first in New Zealand to investigate the extent of patient delay for women with self-detected breast symptoms and the factors influencing this delay. The majority of women saw their doctor within one month of self-detection of a breast symptom, however 14% delayed over three months before seeing their GP. Women who had a family member with breast cancer tended to respond to their breast symptom by delaying seeking medical attention, suggesting that risk perceptions of developing breast cancer may influence delay times in seeking medical help. Results from this study are taken from women referred by their GP to a specialist breast clinic. Certainly, further clarification of the factors that influence delay involving broader patient groups is vital to the development of public education initiatives aiming to encourage women to seek prompt medical evaluation of breast symptoms.