Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa.
Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa.
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DOI：
10.3332/ecancer.2021.1171
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发表时间：
2021
影响因子：
1.8
通讯作者：
Walter FM
中科院分区：
文献类型：
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作者：
Moodley J;Constant D;Mwaka AD;Scott SE;Walter FM
乳腺癌和宫颈癌是撒哈拉以南非洲癌症发病率和死亡率的主要原因。大多数妇女都患有晚期疾病，结果很差。这项研究旨在描述乌干达和南非(SA)可能出现的乳腺癌和宫颈癌症状的预期求助行为、获得医疗保健的障碍以及与较不及时的预期求助相关的因素。我们在2018年8月至12月期间进行了一项基于社区的横断面调查。数据是使用非洲妇女对癌症、乳腺癌和宫颈癌的认识工具从每户随机挑选的一名妇女那里收集的。预期的求助行为被分为等待一周或≥一周寻求帮助。多变量分析确定了与预期求助行为相关的因素。1,758名妇女参与了调查(乌干达873人，南非885人，中位年龄34岁，四分位数范围26-47岁)。大多数人会与亲近的人讨论症状(87.7%的人是乳房症状，83.0%的人是颈部症状)。对于乳房和颈部症状，大多数人期望在一周内到医疗机构寻求治疗：分别为86.1%和88.0%。38.7%的女性预计就诊时会遇到至少1个障碍。缺乏交通或诊所费用是最常见的障碍(24.6%的参与者)。对于癌症和两个国家，报告障碍较多的女性预期寻求及时治疗的可能性明显降低。在南非，农村地区也与较长的预期就诊时间相关，乳腺癌和宫颈癌的调整患病率(APR)为2.92，95%可信区间(CI)为1.48-5.76，调整后患病率为2.42，95%CI为1.08-5.45。改善社区层面的癌症知识并强调及时寻求帮助的重要性的干预措施对于促进及时寻求治疗非常重要。此外，通过减少运输和诊所费用以及解决获得护理方面的地域不平等来解决财务障碍，可帮助妇女及时寻求对可能出现的症状的护理。
Breast and cervical cancers are leading causes of cancer morbidity and mortality in sub-Saharan Africa. Most women present with advanced-stage disease and have poor outcomes. This study aimed to describe anticipated help-seeking behaviour for possible breast and cervical cancer symptoms, barriers to accessing health care and factors associated with less timely anticipated help-seeking in urban and rural settings in Uganda and South Africa (SA). We conducted a cross-sectional community-based survey between August and December 2018. Data were collected from one randomly selected woman per household using the African Women Awareness of CANcer breast and cervical cancer tool. Anticipated help-seeking behaviour was dichotomised into waiting <1week or ≥1 week to seek care. Multivariable analysis identified factors associated with anticipated help-seeking behaviour. One thousand, seven hundred fifty-eight women participated (Uganda 873, SA 885, median age 34, interquartile ranges 26–47). Most would discuss symptoms with someone close to them (87.7% for breast, 83.0% for cervical symptoms). The majority anticipated seeking care from a health facility in <1 week: 86.1% and 88.0%, respectively, for breast and cervical symptoms. 38.7% of women expected to encounter at least 1 barrier when seeking care. Lack of money for transport or clinic costs was the most common barrier (24.6% of participants). For both cancers and in both countries, women who reported more barriers were significantly less likely to anticipate seeking timely care. In SA, rural location was also associated with longer anticipated time to seek care, adjusted prevalence ratio (aPR) 2.92, 95% confidence interval (CI) 1.48–5.76 and aPR 2.42, 95% CI 1.08–5.45 for breast and cervical cancer, respectively. Interventions that improve community level cancer knowledge and highlight the importance of prompt help-seeking for possible symptoms are important to promote timely care seeking. In addition, addressing financial barriers by reducing transport and clinic costs and tackling geographical inequities in access to care could support women in seeking timely care for possible symptoms.
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影响因子：
--
作者：
Bhatia RK;Rayne S;Rate W;Bakwenabatsile L;Monare B;Anakwenze C;Dhillon P;Narasimhamurthy M;Dryden-Peterson S;Grover S
通讯作者：
Grover S
影响因子：
2.9
作者：
Mwaka, Amos Deogratius;Garimoi, Christopher Orach;Lyratzopoulos, Georgios
通讯作者：
Lyratzopoulos, Georgios
影响因子：
5.4
作者：
ANDERSEN, BL;CACIOPPO, JT;ROBERTS, DC
通讯作者：
ROBERTS, DC
影响因子：
3.8
作者：
Moodley, Jennifer;Cairncross, Lydia;Constant, Deborah
通讯作者：
Constant, Deborah
影响因子：
3.7
作者：
Khakbazan Z;Taghipour A;Latifnejad Roudsari R;Mohammadi E
通讯作者：
Mohammadi E