Illness Perception and Delayed Healthcare-Seeking in Urban Chinese Women with Pelvic Organ Prolapse: A Qualitative Study Using the Common-Sense Model.

Abstract

Introduction: Pelvic organ prolapse (POP) is prevalent among postmenopausal women in China, yet many delay care for months or years. Guided by the Common-Sense Model of Self-Regulation (CSM), this study explored illness perceptions and coping experiences among Chinese women with moderate-to-severe POP who delayed healthcare-seeking.

Methods: A descriptive phenomenological design was used. Seventeen women (mean age 61 years; delay range: 12-360 months) were purposively recruited from a tertiary hospital in Guangdong Province. Semi-structured interviews were conducted and analyzed using Colaizzi's seven-step method.

Results: Three main themes emerged: (1) Cognitive representation: Participants lacked POP awareness, attributing symptoms to normal aging or childbirth, minimizing severity due to absence of pain. (2) Coping strategies: Avoidance and concealment behaviors were common due to shame and fear of being a burden. Adult children, especially daughters-in-law, often triggered eventual care-seeking. (3) Appraisal and outcomes: Women reported positive postoperative outcomes but profound regret about delayed care, advocating for better health education.

Conclusions: This study, one of the first CSM-based investigations in this population, explains how cognitive misattributions, emotional distress (shame, fear), and maladaptive coping collectively sustain prolonged healthcare delay in POP. Nurses should implement CSM-based interventions to correct misconceptions, reduce stigma, and engage family members. Findings are exploratory and hypothesis-generating. Future research requires longitudinal designs and rural sample replication.