Dewi Triana Kesuma, Massar Karlijn, Ardi Rahkman, Ruiter Robert A C
Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Department of Clinical Psychology and Mental Health, Faculty of Psychology, Universitas Airlangga, Surabaya, Indonesia.
Psychol Health. 2021 Dec;36(12):1427-1440. doi: 10.1080/08870446.2020.1841765. Epub 2020 Nov 2.
Early presentation with breast cancer symptoms is crucial to the effectiveness of treatment and the affected women's long-term survival. However, in Indonesia, 60-70% of breast cancer patients first present themselves to the hospital in an advanced stage. Knowledge about the determinants of breast cancer early presentation could inform efforts to promote healthcare seeking at earlier symptomatic stages. In the current study, we explored the psychosocial determinants of early presentation among female breast cancer survivors.
Face-to-face semi-structured interviews were conducted with 23 female breast cancer survivors in Surabaya, Indonesia (mean age = 49.8 years). Directed content analysis approach was used to analyse the data.
Half of the respondents underwent breast cancer screening prior to onset of symptoms. Nine determinants of breast cancer early presentation were reflected in the women's responses: (lack of) knowledge, perceived behavioural control, previous health related experiences and risk perceptions, attitudes and beliefs, norms, competing priorities, financial issues, instrumental factors, and health provider factors.
Health promotion efforts should focus on both internal and external psychosocial determinants related to the breast cancer early presentation, and on involving women's social environment as target for education. Additionally, providing accessible and affordable healthcare is important for early presentation.
乳腺癌症状的早期呈现对于治疗效果和患病女性的长期生存至关重要。然而，在印度尼西亚，60%-70%的乳腺癌患者首次到医院就诊时已处于晚期。了解乳腺癌早期呈现的决定因素有助于推动在症状出现早期阶段寻求医疗服务。在本研究中，我们探讨了女性乳腺癌幸存者早期呈现的心理社会决定因素。
对印度尼西亚泗水的23名女性乳腺癌幸存者进行了面对面的半结构化访谈（平均年龄=49.8岁）。采用定向内容分析法对数据进行分析。
一半的受访者在症状出现之前接受过乳腺癌筛查。女性的回答反映了乳腺癌早期呈现的九个决定因素：（缺乏）知识、感知行为控制、既往健康相关经历和风险认知、态度和信念、规范、相互竞争的优先事项、财务问题、工具性因素和医疗服务提供者因素。
健康促进工作应关注与乳腺癌早期呈现相关的内部和外部心理社会决定因素，并将女性的社会环境作为教育目标。此外，提供可及且负担得起的医疗服务对于早期呈现很重要。
