What drives or delays help-seeking for chest pain? A qualitative study

Background Chest pain is a common symptom with causes ranging from harmless to potentially life-threatening. Interpreting its seriousness and deciding whether to seek care can be challenging for individuals. While research has focused on patients with confirmed cardiac diagnoses, less is known about how people experience and evaluate chest pain in general, and how they decide to seek care.

Aim To explore the considerations of people experiencing chest pain and identify the barriers and facilitators influencing their decision to seek medical care.

Design & setting Qualitative study using semi-structured focus groups and individual interviews with adults who had experienced chest pain in primary care.

Method Two focus groups (n=3 each) and nine individual interviews were conducted. Interviews were guided by the Health Belief Model (HBM) and explored barriers and facilitators to care-seeking. Transcripts were analysed thematically. Data collection continued until no new themes emerged.

Results All HBM components shaped help-seeking, often changing as symptoms progressed. Decisions to seek care were influenced by multiple, interacting factors. Barriers included fear of exaggerating symptoms, prior non-cardiac explanations, downplaying symptoms, and practical considerations. Facilitators included severe or persistent symptoms, prior recognition, social support, and positive relationships with healthcare providers. Expectations also influenced decisions, including seeking reassurance about serious illness or advice for non-cardiac or persistent symptoms.

Conclusion Decisions to seek medical care for chest pain are influenced by symptom interpretation, expectations, social support, and trust in healthcare providers. Clear communication, strong doctor-patient relationships, and accessible, reliable information may support timely and appropriate care-seeking.