title: Delay in seeking medical evaluations and predictors of self-efficacy among women with newly diagnosed breast cancer: a longitudinal study.
abstract: BACKGROUND
  Delaying a diagnosis of breast cancer directly and positively impacts survival. Self-efficacy has been shown to be a causal mechanism in a wide range of health behaviors, a measurable trait that predicts behavior across domains, which is strong associated with psychological variables. However, factors predicting self-efficacy of women with suspected breast cancer who delayed or did not delay seeking a breast cancer diagnosis over time have not been identified.
  
  
  OBJECTIVE
  To examine the differences between women who delay and women who did not delay seeking a cancer diagnosis, and key factors predicting self-efficacy over time among women with newly-diagnosed breast cancer.
  
  
  METHODS
  Descriptive, longitudinal design over 2 months following breast cancer diagnostic evaluation.
  
  
  METHODS
  A medical center is located in southern Taiwan.
  
  
  METHODS
  Eighty women with suspected breast cancer were approached and 67 subjects with a positive diagnosis of breast cancer were recruited.
  
  
  METHODS
  Subjects were categorized into women who delayed their diagnosis and women who did not delay their diagnosis. A battery of 5 standardized questionnaires including self-efficacy, anxiety and depression, personality, spiritual support and hope was completed at the first three clinic visits.
  
  
  RESULTS
  Stage of cancer, trait extroversion/neuroticism and spiritual support were significantly different between groups (p<0.05). Subjects who did not delay (β=-1.613, p<0.05), and time that histology results were provided (β=-2.4333, p<0.001) had a significantly predicted negative change in self-efficacy compared to the group that delayed. Hope at the first clinic visit contributed to the change in self-efficacy over time (β=0.391, p<0.001).
  
  
  CONCLUSIONS
  Personal factors affecting a woman's delay in obtaining medical assessment of breast cancer confirmation. Hope impacts self-efficacy of women with suspected breast cancer and interventions to enhance hope during the early stages of breast cancer evaluation require further study.
authors: College of Nursing, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 110, Taiwan, ROC. Electronic address: hsiuju@tmu.edu.tw.
authors: Hsiu-Ju
authors: HJ
authors: Chang
authors: Department of Nursing, St. Mary's Medicine, Nursing and Management College, No. 100, Lane 265, Sec. 2, Sanxing Rd., Sanxing Township, Yilan County 26644, Taiwan, ROC. Electronic address: wenxiang@smc.edu.tw.
authors: Wen-Xiang
authors: WX
authors: Chen
authors: Department of Nursing, National Cheng Kung University, No. 1, Tai-Hsueh Road, Tainan City 701, Taiwan, ROC. Electronic address: chinglan@mail.ncku.edu.tw.
authors: Esther Ching-Lan
authors: EC
authors: Lin
authors: Institute of Education, National Cheng Kung University, No. 1, Tai-Hsueh Road, Tainan City 701, Taiwan, ROC.
authors: Yuk-Ying
authors: YY
authors: Tung
authors: Department of Nursing, University of New Hampshire, Durham, New Hampshire, 217 Hewitt Hall, 4 Library Way, Durham, NH 03824, United States.
authors: Susan
authors: S
authors: Fetzer
authors: Department of Nursing, National Cheng Kung University, No. 1, Tai-Hsueh Road, Tainan City 701, Taiwan, ROC. Electronic address: l30mf@mail.ncku.edu.tw.
authors: Mei-Feng
authors: MF
authors: Lin
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013624:Taiwan
keywords: Breast cancer; Longitudinal study; Patient delay; Psychological distress; Self-efficacy; Spiritual support