Barriers to seeking help


Why do some people who suffer chronic pain avoid seeking help?

There are many factors that can impact the willingness or ability to seek medical help.

There is substantial evidence demonstrating that clinical factors such as pain severity and disability influence help-seeking behaviour.

Reluctance to take analgesics, fear of side effects, and fear of addiction are examples of patient-related factors.

Below we explore other aspects that have been found to impact help-seeking behaviour for pain.

Belief that pain in later life is normal or something that should be expected —The expectation of pain in older age is evident throughout the literature. Most of the qualitative studies on this topic conclude that attributing the cause of pain to ageing can account for patient delay in seeking treatment.

Expectations — People who believe that a certain behaviour will result in a positive outcome are likely to engage in that behaviour; conversely people with low expectations are less likely to engage. Expectations are shaped from past experience and other social-cognitive factors. Within the context of seeking help for chronic pain, poor expectations have been described as a barrier to help-seeking. In other words, individuals may not attend their doctor because they expect no positive outcome and are resigned to the fact that nothing can be done to treat their pain.

Some of these negative expectations may relate to expecting health professionals’ lack of interest and empathy, GP’s lack of specialised knowledge or long waiting time for appointments.

It has been documented that some people expect that they may be labeled as a ‘liar’, a ‘complainer’ or ‘hypochondriac’ when they ask for help, and people in this situation begin to doubt the existence of the sensations that they are experiencing and as a result conceal their pain from others, thereby hampering future help-seeking.

The word ‘help’ can be seen as a sign of vulnerability — This may put people off seeking medical treatment.

Stoic attitudes — Some people attach value to the ability to withstand pain and this can seriously impact on the communication of pain to healthcare professionals. Research conducted in nursing homes found that stoic attitudes were the most frequently cited reason for not seeking treatment.

Encouragement and support from others to find a cure or a treatment

The encouragement and support of others has been described as something that often prompts action, particularly if the person is going through a phase of contemplation.

Understanding chronic pain and the importance of seeking help — Very often, those who delay are unaware that their pain can be treated successfully. Knowledge of treatment options and the awareness of specialist pain clinics can also influence those who have pain.

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