Mohammad Abufaraj, Jood Al-Adwan, Tamara Al-Azzeh, Yara Saddam, Abdalrhman Albassomi, Mohammad Al-Sabbagh, Safwan Abu Khalaf, Abdulrahman Yamin, Amr S Khatatneh, Baha Aldeen Alshraideh, Hana Taha
When a symptom is as visually striking as gross hematuria, the decision to seek care appeared to be driven primarily by symptom visibility rather than belief-based constructs, though causal inferences cannot be drawn from this cross-sectional, single-center study. The model's six constructs did not independently predict care-seeking once hematuria type was considered, suggesting limited additive utility in this context; however, replication in larger and more diverse samples is needed before broader conclusions about HBM applicability are drawn. Importantly, patients with microscopic hematuria-whose condition is no less clinically serious-were less likely to seek care, pointing to a gap that warrants direct attention in future public health planning.
BACKGROUND/OBJECTIVES: Despite broad application of the Health Belief Model (HBM) across a range of clinical contexts, its relevance to patients actively presenting with hematuria remains unexplored. Hematuria may stem from minor self-resolving causes or serious malignancies requiring early intervention. This study aimed to characterize health-seeking behavior in this population and to determine which clinical and belief-based factors predict whether patients pursue medical evaluation.
METHODS: We conducted a cross-sectional study on 150 patients presented with hematuria, enrolled by convenience sampling from a single tertiary-care urology center. Participants completed a self-administered Arabic questionnaire comprising the Champion Revised Health Belief Model Scale and a sociodemographic instrument. Binary logistic regression was used to identify independent predictors of care-seeking. Health-seeking behavior was analyzed in 125 of the 150 enrolled patients; 25 participants were excluded because hematuria was detected solely on urinalysis without personal symptom awareness.
RESULTS: Macroscopic hematuria accounted for 68% of cases and was more common among males (74.5%) and those older than 70 years (85%). Overall, 91% of participants sought or were actively seeking medical care. Among clinical and belief-based variables tested, only hematuria type reached marginal statistical significance: macroscopic presentation was associated with a 2.7-fold higher likelihood of care-seeking relative to microscopic (OR = 2.66, 95% CI 1.00-7.08, p = 0.049). This finding should be interpreted with caution given the marginal p-value and a confidence interval whose lower bound is at 1.0. No HBM construct-including perceived susceptibility, severity, benefits, barriers, confidence, or health motivation-independently predicted this outcome.
CONCLUSION: When a symptom is as visually striking as gross hematuria, the decision to seek care appeared to be driven primarily by symptom visibility rather than belief-based constructs, though causal inferences cannot be drawn from this cross-sectional, single-center study. The model's six constructs did not independently predict care-seeking once hematuria type was considered, suggesting limited additive utility in this context; however, replication in larger and more diverse samples is needed before broader conclusions about HBM applicability are drawn. Importantly, patients with microscopic hematuria-whose condition is no less clinically serious-were less likely to seek care, pointing to a gap that warrants direct attention in future public health planning.