Obesity-specific psychological barriers to timely care: Factors associated with patient delay in endometrial cancer patients with obesity

Aim: To investigate the status and influencing factors of patient delay in endometrial cancer patients with obesity, with a specific focus on the role of weight bias internalization as a unique psychosocial factor. 
Methods: A cross-sectional study was conducted from February 2024 to February 2025. A convenience sample of 251 patients diagnosed with endometrial cancer and BMI ≥28 kg/m² was recruited from a tertiary hospital in Zhengzhou, China. Data were collected using a general information questionnaire, Weight Bias Internalization Scale, Perceived Barriers to Healthcare-Seeking Scale, Simplified Coping Style Questionnaire, and Social Support Rating Scale. Binary logistic regression was performed to identify independent factors associated with patient delay. The study was approved by the Institutional Review Board of the affiliated hospital.
Results: The prevalence of patient delay was 43.8%. Logistic regression revealed that higher weight bias internalization (OR=1.027, 95%CI: 1.004-1.051), greater perceived barriers to healthcare-seeking (OR=1.047, 95%CI: 1.001-1.094), and perceived financial burden (OR=2.952, 95%CI: 1.055-8.260) were independent risk factors. Active coping style (OR=0.942, 95%CI: 0.896-0.990), regular physical examination habits (OR=0.412, 95%CI: 0.182-0.935), and higher education level (junior high school: OR=0.376, 95%CI: 0.185-0.765; senior high school and above: OR=0.128, 95%CI: 0.053-0.310) were protective factors.
Conclusion: Patient delay is common among endometrial cancer patients with obesity and is influenced by multi-level factors. Beyond financial burden, health behaviors, and education level, the condition is uniquely associated with weight bias internalization. Clinical interventions should incorporate financial support, health education, and targeted psychological support, with particular emphasis on reducing healthcare-related concerns.

Du Xiaobing is a Chief Nurse with10 years of clinical experience and a master's student specializing in obstetrics and gynecology nursing. Based in Xuchang, Henan, she has actively participated in multiple nursing research and quality improvement projects. Her academic achievements include publishing multiple core journal papers and presenting posters at the International Council of Nurses (ICN) Congress.