Table 1 Qualitative themes, categories, and example quotes.
From: The journey of lung cancer patients from symptoms to diagnosis in Greece. A mixed methods approach
Theme | Category | Example quote |
|---|---|---|
The symptoms before seeking medical attention | Respiratory symptoms | “Before the diagnosis, I had a persistent cough for some time. I thought it was due to COPD so I started taking antibiotics, antitussives, and inhalers on my own. Eventually, the hemoptysis started. Then I visited the doctor.” |
“I had chronic shortness of breath. But some nights I couldn’t breathe.” | ||
“I felt like I had something stuck in my throat, I was trying to cough and “break” it. If I had gone to the doctor, then I could have been saved. It was a premonition.” | ||
“I coughed for almost 2 years. I used to smoke and thought that’s why I coughed. Towards the end, I also had back pain. At first, I thought it was because of work. Eventually, I went to the ER.” | ||
“I thought it was due to smoking. I wasn’t paying attention. It didn’t affect me in any way.” | ||
“I had to cough up blood to go see the doctor.” | ||
Pain symptoms | “My cousin also had back pains from work. I thought it was the same for me. It lasted 15 days. Then I went to the hospital.” | |
“After I was diagnosed, I remembered feeling a “pinch” in my chest on the side where I have the tumor like it was a nerve pain.” | ||
Psychological symptoms | “My father didn’t eat. He was not in a good mood. This went on for three months. But he wouldn’t go to the doctor. He only went to get the flu shot.” | |
“Dad doesn’t know that he has cancer. Three months before the diagnosis, he was very depressed.” | ||
The journey within the healthcare system | Physicians’—healthcare system missteps | “I had symptoms, but I didn’t pay attention. I went to the hospital with an allergy. They treated me and I got burns on my hands.” |
“When my sister got sick, I went to get a checkup as well. Of course, the pulmonologist who saw me only did an x-ray and spirometry, and nothing showed up. But I don’t think he looked at them properly.” | ||
“The pulmonologist I first visited dismissed me before he’d seen the tests. He said to come back after three months. Of course, I found another doctor.” | ||
“I regularly visit a GP in the health center. The tests I did, have shown cancer for years. He never told me.” | ||
“If it wasn’t for that unacceptable doctor at another Hospital, I would have found the problem earlier. However, the local primary health care center I visited the next time for my symptoms was excellent.” | ||
“From the very beginning when I started with the tests, I visited a surgeon. If I hadn’t been presented with the thyroid problem, I wouldn’t have known that I needed to visit an oncologist.” | ||
“I was feeling some dizziness before I was diagnosed, I thought it was my eyesight. The ophthalmologist, of course, had attributed it to age at the time.” | ||
“The doctors killed me. They gave me the wrong drugs for months. I had a blood clot in my leg, they finally cut it off at the knee. I don’t care about the cancer. It’s my leg that makes me sad.” | ||
“Suddenly, I got a hoarse voice. I went to a general practitioner to see me. He gave me pills and spray. But my voice didn’t come back.” | ||
“I went to a bunch of doctors only in the end to be told that I have cancer. They even sent me to a plastic surgeon.” | ||
“For 1.5 years after the surgery, I visited a surgeon. I didn’t know I was supposed to visit an oncologist. No one told me. At some point, I started having instability. Now I visit an oncologist because I have metastases in my head.” | ||
Administrative problems | “They gave me a hard time at the hospital until they could get me an appointment to have my tests.” | |
“The biopsy took too long to come out.” | ||
“I was sent to have a biopsy at a private center. They asked for 1500€. At the hospital, it was almost impossible to get an appointment for a bronchoscopy.” | ||
“CT scan should be included in the primary care.” | ||
The effect of Covid-19 pandemic | “I couldn’t make an appointment for tests so that I could start my treatment because of the lockdown.” | |
“I had finished treatments. In February 2020 I had a re-examination. A change in the lung was found. I had to have additional tests. Due to Covid-19 they wouldn’t let me make an appointment at the hospital. In June when we were now allowed to go, I returned to the hospital with metastases in my head.” | ||
“Because of the covid, they kept canceling my test appointments. It took me 3 months to start treatment.” |
