WHY DO DYSPEPTIC PATIENTS OVER THE AGE OF 50 CONSULT THEIR GENERAL-PRACTITIONER - A QUALITATIVE INVESTIGATION OF HEALTH BELIEFS RELATING TODYSPEPSIA

Background. The prognosis of late-diagnosed gastric cancer is poor, ye t less than half of dyspeptic patients consult their general practitio ner (GP). Aim. To construct an explanatory model of the decision to co nsult with dyspepsia in older patients. Method. A total of 75 patients over the age of 50 years who had consulted with dyspepsia at one of t wo inner city general practices were invited to an in-depth interview. The interviews were taped, transcribed and analysed using the compute r software NUD.IST, according to the principles of grounded theory. Re sults. Altogether, 31 interviews were conducted. The perceived threat of cancer and the need for reassurance were key influences on the deci sion to consult Cues such as a change in symptoms were important in pr ompting a reevaluation of the likely cause. Personal vulnerability to serious illness was often mentioned in the context of family or friend s' experience, but tempered by an individual's life expectations. Conc lusion. Most patients who had delayed consultation put their symptoms down to 'old age' or 'spicy food'. However, a significant minority wer e fatalistic, suspecting the worst but fearing medical interventions.