Pathways from symptoms to medical care: a descriptive study of symptom development and obstacles to early diagnosis in brain tumour patients

Abstract

Most spouses witnessed months of global dysfunction preceding the symptom leading to physician consultation. The patient factors 'less alien symptoms', 'personality change' and 'avoidance'; the spouse factors 'spouse's passivity' and 'spouse's successive adaptation'; and the physician factors 'reasonable alternative diagnosis', 'physician's inflexibility' and 'physician's personal values' were identified as obstacles on the pathway to appropriate medical care. The importance of acknowledging the power of the spouse as a provider of substantial information from everyday life facilitating differential diagnosis is stressed.