'I Thought I Could Cope Alone': Understanding Barriers to Support-Seeking Among Thyroid Cancer Survivors Through an Integrated Theoretical Lens.

BACKGROUND

Thyroid cancer has a favourable prognosis, yet many survivors experience ongoing psychological and social challenges. Although support is available, it is often underused. This study explored barriers to support-seeking in the UK.

METHODS

An inductive, qualitative approach was taken. Twenty-five adults with papillary or follicular thyroid cancer were recruited through an NHS Trust and a national charity. Semi-structured interviews were conducted and thematically analysed, with the findings compared to existing bodies of theory.

RESULTS

Barriers clustered into two domains. Domain A focused on personal illness representations: (1) self-sufficiency and low perceived need ('I thought I could cope alone'), (2) altruistic reluctance ('others need it more than me'), and (3) limited sense of belonging due to age or cancer type ('not for people like me'). Domain B captured structural influences: (4) absence of proactive follow-up ('care ends at discharge') and (5) support options that did not meet individual preferences ('one-size doesn't fit all'). An approach that combined the Common-Sense Model of Illness Representations and Andersen's Behavioural Model of Health Services Use was most helpful in contextualising these findings. This approach showed how beliefs about coping, emotional regulation, and moral comparisons intersect with service design, information quality, and enabling resources to limit engagement with psychosocial support.

CONCLUSION

Barriers arise through the interaction of belief-based and system-level factors. Clinically, routine assessment of illness perceptions, normalisation of help-seeking, proactive survivorship follow-up, and flexible, tailored support options may improve engagement. Embedding psychosocial care within standard follow-up could help position emotional well-being at the centre of thyroid cancer recovery.