Symptom appraisal, help-seeking and perceived barriers to healthcare seeking in Uganda: an exploratory study among women with potential symptoms of breast and cervical cancer.
Symptom appraisal, help-seeking and perceived barriers to healthcare seeking in Uganda: an exploratory study among women with potential symptoms of breast and cervical cancer.
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DOI：
10.1136/bmjopen-2020-041365
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发表时间：
2021-02-05
期刊：
影响因子：
2.9
通讯作者：
Moodley J
中科院分区：
文献类型：
--
作者：
Mwaka AD;Walter FM;Scott S;Harries J;Wabinga H;Moodley J
我们评估了可能患有乳腺癌和宫颈癌症状的乌干达社区妇女识别异常身体变化、解释和归因以及寻求帮助行为的过程，以便为旨在促进及时发现和诊断癌症的健康干预措施提供信息。定性深度访谈。乌干达的农村和城市社区。参加非洲妇女癌症意识横断面调查并披露潜在乳腺癌和宫颈癌症状的女性符合资格；招募是有目的的。访谈在妇女家里进行，持续 40 至 90 分钟，进行录音、逐字转录并翻译成英文。主题分析用于确定主题和次主题，并以治疗途径模型的概念框架为基础。 23 名女性接受了采访：其中 10 名有乳腺癌的潜在症状，13 名有宫颈癌的潜在症状。症状评估和寻求帮助的主题包括：（1）异常身体感觉的检测和解释； (2)关于身体改变的非专业咨询； (3) 将疾病归因于身体变化的迭代过程； (4) 出于对隐私的担忧和害怕受到污名化，限制向非专业人士披露症状； (5) 从多种来源寻求帮助，包括传统和生物医学保健从业者，以及 (6) 寻求帮助存在多种障碍，包括等待时间长、缺乏药品、医疗保健专业人员缺勤以及缺乏交通和医疗费用。具有潜在乳腺癌和宫颈癌症状的女性要经历复杂的症状解释、归因症状或推断疾病的过程，并在寻求帮助和治疗之前进行咨询。提高社区对乳腺癌和宫颈癌症状的了解，并解决寻求健康的障碍，可以导致及时、适当的症状评估和寻求帮助，并有助于改善癌症结果。
We assessed the process of recognising abnormal bodily changes, interpretations and attributions, and help-seeking behaviour among community-based Ugandan women with possible symptoms of breast and cervical cancer, in order to inform health interventions aiming to promote timely detection and diagnosis of cancer. Qualitative in-depth interviews. Rural and urban communities in Uganda. Women who participated in the African Women Awareness of CANcer cross-sectional survey who disclosed potential breast and cervical cancer symptoms were eligible; recruitment was purposive. Interviews were conducted in women’s homes, lasted between 40 and 90 min, were audio-recorded, transcribed verbatim and translated to English. Thematic analysis was used to identify themes and subthemes, underpinned by the conceptual framework of the Model of Pathways to Treatment. 23 women were interviewed: 10 had potential symptoms of breast cancer and 13 of cervical cancer. Themes regarding symptom appraisal and help-seeking included the: (1) detection and interpretation of abnormal bodily sensations; (2) lay consultations regarding bodily changes; (3) iterative process of inferring and attributing illnesses to the bodily changes; (4) restricted disclosure of symptoms to lay people due to concerns about privacy and fear of stigmatisation; (5) help-seeking from multiple sources including both traditional and biomedical health practitioners, and (6) multiple perceived barriers to help-seeking including long waiting times, lack of medicines, absenteeism of healthcare professionals, and lack of money for transport and medical bills. Women with potential symptoms of breast and cervical cancer undergo complex processes of symptom interpretation, attributing symptoms or inferring illness, and lay consultations before undertaking help-seeking and management. Increasing community understanding of breast and cervical cancer symptoms, and tackling perceived barriers to health-seeking, could lead to prompt and appropriate symptom appraisal and help-seeking, and contribute to improving cancer outcomes.
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