Table 2.
Themes, subthemes and supporting quotes obtained from data analysis.
| Themes | Subthemes | Supporting quotes |
|---|---|---|
| Cognitive explanation of illness | Lack of disease knowledge | - “I was pregnant, and people around me also had localized swelling during pregnancy. Therefore, I failed to take it seriously and bought some medicine on my own.” (C3) |
| - “The edema was caused by less activity after surgery and didn’t realize that there was a problem with my kidneys.” (C5) | ||
| Symptom self-avoidance | - “I hate the smell of disinfectant the most. Those doctors ask me to have exams in case of medical consultation, which costs money and suffering.” (C7) | |
| - “I was very uncomfortable during a colonoscopy at the hospital before, which was a negative experience for me, so I preferred to take medicine and didn’t want to go to the hospital for a checkup.” (C8) | ||
| Plausible symptom attribution | - “I noticed that my skin was a little darkened and slightly puffy, but I thought it was caused by my fishing some time ago, which was not a big problem. Thus, the medical consultation was delayed for such a long time.” (C10) | |
| - “My physical fitness has always been very good. After finding that my left hand was more swollen than the right one, I thought it was caused by swimming, which should be no problem.” (C7) | ||
| Negative psychological emotions | Negative attitude towards medical consultation | - “Now I have been diagnosed with diabetic nephropathy, which certainly could not be cured, and it would be of no use to seek medical consultation.” (C2) |
| - “There is no point in seeking medical consultation.” (C13) | ||
| Strong stigma | - “If I were diagnosed with a disease during my pregnancy, others would gossip about me and label me. I can’t live with the gossip of others.” (C3) | |
| - “Our peers are all working outside to support the families. They will make fun of me, knowing that I go to the hospital with a disease.” (C12) | ||
| Traditional feudal thoughts | - “Perhaps my fate is that I am destined to have this disease, and it will be no help seeking medical consultation.” (C11) | |
| - “Maybe my life is doomed to have all the suffering.” (C3) | ||
| Limited medical and health resources | Impact of public health emergency | - “Initially, when I felt sick, I wanted to go to the hospital. However, due to the epidemic control during that period, everyone was supposed to stay at home. The hospital was crowded with people, and I was worried about the terrible outcome of being infected.” (C9) |
| - “I traveled to other cities for work during the time I felt sick. Due to the epidemic, I had to provide travel and health codes for check-in before entering the hospital. Moreover, I had to be quarantined for 14 days before medical consultation for traveling through medium to high-risk areas. I thought it was too much trouble, and I failed to have a checkup.” (C12) | ||
| Challenges in primary medical care | - “A few months ago, I went to see a doctor who specialized in TCM with the complaint of dizziness. He asked me about my condition and informed me that it was a normal reaction to old age. He prescribed some decoctions for regulation. I thought it was no big problem; thus, I followed the advice and drank the decoctions. There was a period of improvement, and I couldn’t predict that it would become so serious now.” (C11) | |
| - “I went to consult the doctor in our town, and he said that the abdominal distention and diarrhea might be due to inflammation of the gastrointestinal tract. After taking the medicine for 2 months, it didn’t get better and got even worse.” (C14) |