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Applying symptom appraisal models to understand sociodemographic differences in responses to possible cancer symptoms: a research agenda

Whitaker, KL; Scott, SE; Wardle, J; (2015) Applying symptom appraisal models to understand sociodemographic differences in responses to possible cancer symptoms: a research agenda. British Journal of Cancer , 112 (S1) S27 - S34. 10.1038/bjc.2015.39. Green open access

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Abstract

Background: Sociodemographic inequalities in the stage of diagnosis and cancer survival may be partly due to differences in the appraisal interval (time from noticing a bodily change to perceiving a reason to discuss symptoms with a health-care professional). A number of symptom appraisal models have been developed describing the psychological factors that underlie how people make sense of symptoms, although none explicitly focus on sociodemographic characteristics. / Methods: We therefore conducted a conceptual review synthesising all symptom appraisal models, and focus on potential links with sociodemographics that could be the focus of future research. / Results: Common psychological elements across nine symptom appraisal models included knowledge, attention, expectation and identity, all of which could be sensitive to sociodemographic factors. For example, lower socioeconomic status (SES), male sex and older age are associated with lower health literacy generally and lower cancer symptom knowledge. Limited attentional resources, lower expectations about health and lack of social support also hamper symptom interpretation, and would be likely to be more prevalent in those from lower SES backgrounds. Symptom heuristics (‘rules of thumb’) may lead to symptoms being normalised because they are common within the social network, potentially disadvantaging older populations. / Conclusions: A better understanding of the processes through which people interpret their symptoms, and the way these processes differ by sociodemographic factors, could help guide the development of interventions with the aim of reducing inequalities in cancer outcomes.

Type: Article
Title: Applying symptom appraisal models to understand sociodemographic differences in responses to possible cancer symptoms: a research agenda
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/bjc.2015.39
Publisher version: http://dx.doi.org/10.1038/bjc.2015.39
Language: English
Additional information: This article is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International licence (CC BY-NC-ND 4.0). This licence allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licences are available at http://creativecommons.org/licenses/by/4.0.
Keywords: cancer; symptom; bodily change; appraisal; patient presentation; appraisal interval; sociodemographics; inequalities
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1465671
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