title: Understanding the reasons why patients delay seeking treatment for oral cancer symptoms from a primary health care professional: an integrative literature review.
abstract: OBJECTIVE
  The purpose of this integrative literature review was to investigate existing research on the reasons why patients delay in seeking treatment for oral cancer symptoms from a primary health care professional.
  
  
  METHODS
  The systematic approach developed by Cooper (1984) was the guiding framework for this integrative review. Cooper (1984) identifies the process of conducting an integrative review as encompassing the following five stages: (a) problem formulation, (b) data collection, (c) evaluation of data points, (d) data analysis and interpretation, and (e) public presentation of results.
  
  
  RESULTS
  Despite different research designs employed and sample sizes ranging from 15 to 559, three major themes emerged from the 16 studies included in the review, all of which are directly related to the reasons why people delay seeking treatment for oral cancer symptoms: Patient Sociodemographic Characteristics; Health Related Behaviours, and Psychosocial Factors.
  
  
  CONCLUSIONS
  Overall, this integrative review demonstrates the complexity surrounding the reasons why patients delay in seeking help for oral cancer treatment. The association between knowledge and patient delay has implications for information provision about cancer to those at risk of developing the disease. The relationship between socioeconomic status and patient delay behaviour warrants further investigation as this has been shown to be an influential factor in the study of patient delay. The meaning of many of the investigated psychosocial factors (e.g. an individuals' symptom interpretation/attribution, disclosure of symptoms to significant others, social priorities), have not been discussed in detail and the research is not theory driven.
authors.affiliation: Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland. Electronic address: b.noonan@ucc.ie.
authors.forename: Brendan
authors.initials: B
authors.lastname: Noonan
mesh_terms: D000328:Adult; D000368:Aged; D032882:Comprehension; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011320:Primary Health Care; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Delayed presentation; Diagnostic delay; Patient delay; Treatment delay