Health seeking behavior for cervical cancer in Ethiopia: a qualitative study
Health seeking behavior for cervical cancer in Ethiopia: a qualitative study
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DOI：
10.1186/1475-9276-11-83
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发表时间：
2012-12-29
影响因子：
4.8
通讯作者：
Russell, Fiona M.
中科院分区：
文献类型：
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作者：
Birhanu, Zewdie;Abdissa, Alemseged;Russell, Fiona M.
背景：虽然宫颈癌是埃塞俄比亚妇女癌症相关发病和死亡的主要原因，但缺乏关于社区对该疾病的认识的信息。方法：在埃塞俄比亚西南部吉马地区和首都亚的斯亚贝巴的农村环境中，与男性、女性和社区领导人进行焦点小组讨论。数据是用录音机记录下来的，现场记录是逐字逐句从当地语言译成英语的。使用健康信念模型作为框架确定了关键类别和专题框架，并使用受访者自己的话作为说明在叙述中提出。结果：参试者对宫颈癌的认知程度很低。然而，一旦症状得到解释，参与者对疾病的严重程度有了很高的认识。宫颈癌的病因被认为是由于违反社会禁忌或从事不可接受的行为。因此，人们认为现代治疗的益处非常低，而且发现了寻求任何类型治疗的各种障碍，包括认识和获得适当保健服务的机会有限。患有子宫颈癌的妇女被社会排斥，得不到情感支持。此外，上述因素都造成寻求任何保健服务的延误。对于疾病的早期阶段，传统疗法是最优选的治疗方案。然而，由于大多数病例出现较晚，治疗方案无效，导致求医行为反复出现，在传统疗法和现代治疗方法之间交替。结论：由于对宫颈癌病因的认识存在误区，患者普遍缺乏对宫颈癌的认识和就诊行为。深刻的社会后果和排斥是常见的。由于各种社会心理和卫生系统原因，获得诊断和治疗服务的机会很少。在引入或扩大宫颈癌预防计划之前，必须通过适当的社区层面行为改变沟通来解决影响求医行为的社会文化障碍和卫生服务相关因素。
Background: Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease.Methods: Focus group discussions were conducted with men, women, and community leaders in the rural settings of Jimma Zone southwest Ethiopia and in the capital city, Addis Ababa. Data were captured using voice recorders, and field notes were transcribed verbatim from the local languages into English language. Key categories and thematic frameworks were identified using the health belief model as a framework, and presented in narratives using the respondents own words as an illustration.Results: Participants had very low awareness of cervical cancer. However, once the symptoms were explained, participants had a high perception of the severity of the disease. The etiology of cervical cancer was thought to be due to breaching social taboos or undertaking unacceptable behaviors. As a result, the perceived benefits of modern treatment were very low, and various barriers to seeking any type of treatment were identified, including limited awareness and access to appropriate health services. Women with cervical cancer were excluded from society and received poor emotional support. Moreover, the aforementioned factors all caused delays in seeking any health care. Traditional remedies were the most preferred treatment option for early stage of the disease. However, as most cases presented late, treatment options were ineffective, resulting in an iterative pattern of health seeking behavior and alternated between traditional remedies and modern treatment methods.Conclusion: Lack of awareness and health seeking behavior for cervical cancer was common due to misconceptions about the cause of the disease. Profound social consequences and exclusion were common. Access to services for diagnosis and treatment were poor for a variety of psycho-social, and health system reasons. Prior to the introduction or scale up of cervical cancer prevention programs, socio-cultural barriers and health service related factors that influence health seeking behavior must be addressed through appropriate community level behavior change communications.