Understanding pathways to breast cancer diagnosis among women in the Western Cape Province, South Africa: a qualitative study
Understanding pathways to breast cancer diagnosis among women in the Western Cape Province, South Africa: a qualitative study
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DOI：
10.1136/bmjopen-2015-009905
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Momberg, Mariette
中科院分区：
文献类型：
--
作者：
Moodley, Jennifer;Cairncross, Lydia;Momberg, Mariette
目的：本研究的目的是探索和了解女性乳腺癌诊断的途径和影响这一过程的因素。设计和背景：对南非开普敦一家三级乳腺癌诊所的客户进行了深度访谈。以治疗途径模型框架的理论概念为基础，进行了专题分析。参与者：20名女性在被诊断为乳腺癌的一周内接受了采访。结果：从发现身体变化到诊断乳腺癌的平均时间为8.5个月。乳房自我意识的缺失和对乳腺癌症状的认识延迟了女性将身体变化解释为异常的时间。所有女性都是第一次注意到乳房肿块；然而，在出现其他症状之前，许多人并不认为这是不正常的。总体健康状况良好，将症状归因于衰老，以及过去的良性乳房疾病，导致妇女对身体变化感到自满。对家庭成员的披露是寻求医疗保健的诱因。妇女获得的初级保健服务的最初类型受到对所提供的每种服务的认识、财政、结构因素以及与服务的实际位置有关的个人安全的影响。结论：症状评估和解释对延迟表现有重要作用。为了改善对乳腺癌的及时诊断，需要采取干预措施，增强妇女对发现乳房变化的信心，提高对乳腺癌症状的认识，消除误解，并鼓励迅速寻求帮助的行为。
Objectives: The aim of this study was to explore and understand women's pathways to breast cancer diagnosis and factors influencing this journey.Design and setting: Indepth interviews were conducted with clients at a tertiary level breast cancer clinic in Cape Town, South Africa. A thematic analysis was performed underpinned by the theoretical concepts of the Model of Pathways to Treatment framework.Participants: 20 women were interviewed within 1 week of being diagnosed with breast cancer.Results: The average time between discovery of bodily changes to breast cancer diagnosis was 8.5 months. Deficits in breast self-awareness and knowledge of breast cancer symptoms delayed women's interpretation of bodily changes as being abnormal. All women first noticed breast lumps; however, many did not perceive it as abnormal until additional symptoms were present. General good health, attribution of symptoms to ageing, and past benign breast disease resulted in women being complacent about bodily changes. Disclosure to family members served as a trigger to seek healthcare. The initial type of primary level care services women accessed was influenced by perceptions of care each service provided, finances, structural factors, and personal safety related to the physical location of services.Conclusions: Symptom appraisal and interpretation contributed significantly to delayed presentation. To improve timely diagnosis of breast cancer, interventions that increase women's confidence in detecting breast changes, improve knowledge of breast cancer symptoms, address myths, and encourage prompt help-seeking behaviour are required.