Stages in the Model of Delay in Seeking Treatment

Safer's (1979) model of delay in seeking treatment outlines a three-stage process that individuals go through when experiencing potential symptoms of illness before seeking medical attention. These stages are appraisal delay, illness delay, and utilisation delay. Delays in any of these stages can have significant implications for health outcomes.

Appraisal Delay

Appraisal delay refers to the time taken for an individual to recognise that their symptoms are potentially indicative of an illness. This stage involves interpreting bodily sensations and deciding whether they warrant further attention. Several factors can influence appraisal delay, such as:

• Prior experience with illness: Individuals with previous experience of a particular illness might be quicker to appraise similar symptoms as serious. Conversely, someone with no prior experience might dismiss the symptoms as insignificant.
• Perceived severity: Symptoms perceived as severe or disruptive are more likely to prompt a quicker appraisal. For example, sudden and intense chest pain is more likely to raise concern than occasional mild headaches.
• Cultural beliefs and attitudes: Cultural norms can shape how individuals interpret and respond to bodily sensations. Some cultures may encourage stoicism and downplaying symptoms, while others might promote seeking help sooner.

Illness Delay

Once an individual acknowledges the possibility of illness, illness delay sets in. This stage involves the time taken from the point of appraisal to actually deciding to seek medical attention. Factors influencing illness delay include:

• Perceived vulnerability: Individuals who perceive themselves as less susceptible to illness might delay seeking help. For example, a young and healthy individual might dismiss symptoms they would consider serious in an older person.
• Fear and anxiety: Fear of the potential diagnosis, treatment procedures, or social stigma associated with a particular illness can lead to delays. For example, someone suspecting a sexually transmitted infection might delay seeking help due to embarrassment or fear of judgement.
• Practical barriers: Practical considerations like work commitments, childcare responsibilities, or financial constraints can hinder timely help-seeking. For instance, an individual without access to affordable healthcare might postpone seeking medical attention.

Utilisation Delay

Utilisation delay describes the time lapse between the decision to seek medical attention and actually receiving care. This delay can be influenced by:

• Availability of healthcare services: Long wait times for appointments, limited access to specialists, or geographical distance from healthcare facilities can contribute to utilisation delay.
• Insurance coverage and financial resources: Individuals with limited or no health insurance might face delays in accessing necessary medical services due to cost concerns.
• Logistical challenges: Navigating the healthcare system, obtaining referrals, and scheduling appointments can pose logistical hurdles that lead to delays in receiving timely care.

Conclusion

Safer's model highlights the complex interplay of factors contributing to delays in seeking treatment. Understanding these stages and their influencing factors is crucial for healthcare professionals to provide timely interventions and improve health outcomes. Addressing potential delays requires multifaceted approaches that consider individual beliefs and behaviours, as well as systemic barriers within the healthcare system.

**Source:** Safer, M. A. (1979). Delay in seeking medical care: A review of the literature. *American Journal of Public Health, 69*(12), 1097-1103.