Mburu Waruiru, Boamah Mensah Adwoa Bemah, Virnig Beth, Amuasi John H, Awuah Baffour, Porta Carolyn M, Osei-Bonsu Ernest, Kulasingam Shalini
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Womens Health Rep (New Rochelle). 2021 Jul 16;2(1):234-244. doi: 10.1089/whr.2020.0117. eCollection 2021.
Breast cancer is the leading cause of cancer death among Ghanaian women and most women are identified once they develop symptoms. Women then must navigate a complex health care system to get diagnosed and receive orthodox medicine. We describe Ghanaian women's pathways of care from breast cancer-related symptom detection to treatment receipt. We conducted a qualitative study using an empirical phenomenological approach. We used a purposive sampling technique to recruit 31 women with breast cancer who were receiving treatment at Komfo Anokye Teaching Hospital in Kumasi, Ghana. They participated in semistructured in-depth interviews between November 2019 and March 2020. All interviews were transcribed verbatim and analyzed using a deductive coding approach. Women navigate approximately nine steps from symptom detection to receiving orthodox breast cancer treatment. The breast cancer care pathway is not linear and women frequently move among different management approaches, including alternative therapy (faith healing and traditional herbal healing). All the women detected the symptoms themselves. Some of the women sought orthodox medicine due to information from the media. Alternative therapy providers play a critical role in the breast cancer diagnosis and care pathways in Ghana underscoring the need to formally integrate them into the health care system. Breast cancer awareness programs through the media and educational programs aimed at alternative therapy providers may reduce the time from symptom detection to receipt of orthodox medicine.
乳腺癌是加纳女性癌症死亡的主要原因，大多数女性在出现症状后才被确诊。随后，这些女性必须在复杂的医疗体系中寻求诊断并接受正统医学治疗。我们描述了加纳女性从乳腺癌相关症状发现到接受治疗的就医过程。我们采用实证现象学方法进行了一项定性研究。我们运用目的抽样技术，招募了31名在加纳库马西的Komfo Anokye教学医院接受治疗的乳腺癌女性患者。她们在2019年11月至2020年3月期间参与了半结构化深度访谈。所有访谈均逐字转录，并采用演绎编码方法进行分析。女性从症状发现到接受正统乳腺癌治疗大约要经历九个步骤。乳腺癌的就医过程并非线性，女性常常在不同的治疗方法之间转换，包括替代疗法（信仰疗法和传统草药疗法）。所有女性都是自己发现症状的。一些女性因媒体信息而寻求正统医学治疗。替代疗法提供者在加纳乳腺癌的诊断和就医过程中发挥着关键作用，这凸显了将其正式纳入医疗体系的必要性。通过媒体开展的乳腺癌宣传项目以及针对替代疗法提供者的教育项目，可能会缩短从症状发现到接受正统医学治疗的时间。
