Health-Seeking Behavior for Occupational Diving Injuries among Traditional Fishermen: A Qualitative Study

Vollständiger Abstract

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Introduction: Diving-related injuries remain a major occupational health risk among coastal fishermen. It is crucial to examine health-seeking behavior among traditional diving fishermen to improve prevention strategies and early management for this high-risk occupational group. Methods: This qualitative study used purposive sampling. The participants were 17 active or former diving fishermen and 13 healthcare workers from coastal primary healthcare centers (Puskesmas) across Lombok Island, Indonesia. Data were collected through focus group discussions and analyzed thematically using Andersen's predisposing, enabling, and perceived need framework. Results: The health-seeking behavior of traditional diving fishermen is influenced by their perception of the severity of diving-related injuries, referred to as perceived need. Predisposing factors include the normalization of occupational risks based on empirical experience, culturally influenced interpretations of symptoms, and peer support. Enabling factors include the cost of treatment, perceptions of unclear referral pathways, and previous negative experiences with primary healthcare services. Healthcare providers also acknowledged that their capacity to manage diving-related injuries remains limited. Conclusion: The interaction of occupational risk normalization, perceived need, and healthcare system barriers appears to contribute to delayed healthcare utilization among traditional diving fishermen. These factors suggest that the limited use of formal healthcare services is more likely to reflect substantial underreporting than a genuinely low incidence of diving-related injuries. These findings highlight the need for coordinated multilevel interventions to improve timely healthcare utilization in this high-risk occupational group.