探索影响儿童癌症治疗项目中寻求治疗决策和留存率的因素：加纳父母的观点
Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana.
作者信息
Renner Lorna Awo, McGill Deborah
机构信息
University of Ghana School of Medicine and Dentistry, Ghana.
University of Liverpool, UK.
出版信息
Ghana Med J. 2016 Sep;50(3):149-156.
BACKGROUND
Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings.
AIM
To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control.
METHOD
This exploratory qualitative study was conducted based on an interpretative epistemology using a social constructionist approach. Purposive sampling of parents attending the Paediatric Oncology Unit, Korle Bu Teaching Hospital in Accra, Ghana was undertaken. Twelve semi-structured moderate interviews and two small focus group discussions with a total of seven participants were undertaken. Data analysis was through thematic content analysis.
RESULTS
Five major themes emerged. Knowledge and perceptions revealed a total lack of appropriate knowledge prior to diagnosis. Health-seeking behaviour was determined by interplay of individual and environmental factors. Orthodox medical treatment was largely perceived favourably. The impact of cancer on parents and children included psychological, physical and socioeconomic effects. Financial, spiritual and psychosocial support helped in coping. Parents recommended public education and health financing to address the major barriers.
CONCLUSION
Broad social determinants and experiences influence parental decision making for children with cancer. This implies Health Promotion strategies with multi-sectorial involvement will be required for effective implementation of the National Strategy for Cancer Control.
FUNDING
Funded by authors.
背景
加纳等发展中国家儿童癌症存活率极低。有必要确定导致就诊延迟和治疗中断的原因，这些是存活率低的主要原因。了解这些问题可为资源有限环境下的儿童癌症控制提供有效策略。
目的
探讨影响加纳癌症患儿家长在寻求医疗和坚持治疗方面决策的因素，以便提供指导儿童癌症控制公共卫生干预措施的信息。
方法
本探索性定性研究基于一种诠释性认识论，采用社会建构主义方法。对加纳阿克拉科勒布教学医院儿科肿瘤科就诊的家长进行了目的抽样。进行了12次半结构化深度访谈和2次小型焦点小组讨论，共有7名参与者。数据分析采用主题内容分析法。
结果
出现了五个主要主题。知识与认知显示，诊断前完全缺乏适当知识。寻求医疗行为由个人和环境因素的相互作用决定。传统医学治疗总体上得到认可。癌症对家长和孩子的影响包括心理、身体和社会经济方面的影响。经济、精神和心理社会支持有助于应对。家长建议开展公众教育和卫生筹资以消除主要障碍。
结论
广泛的社会决定因素和经历影响癌症患儿家长的决策。这意味着有效实施国家癌症控制战略需要多部门参与的健康促进策略。
资金来源
作者自筹资金。
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