Department of Nursing Science, Faculty of Health and Social Science, Bournemouth University, Bournemouth, UK.
Centre for Psychosocial Research in Cancer, Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
BMC Womens Health. 2023 Jul 10;23(1):366. doi: 10.1186/s12905-023-02508-8.
Although there may be theoretical support linking positive health outcomes with cancer disclosure to social networks, women from contexts such as Ghana where cancer is not openly talked about may have concerns around breast cancer disclosure. Women may not be able to share their experiences about their diagnosis, which may prevent them from receiving support. This study aimed to obtain the views of Ghanaian women diagnosed with breast cancer about factors contributing to (non) disclosure.
This study is based on secondary findings from an ethnographic study that employed participant observation and semi-structured face to face interviews. The study was conducted at a breast clinic in a Teaching Hospital in southern Ghana. 16 women diagnosed with breast cancer (up to stage 3); five relatives nominated by these women and ten healthcare professionals (HCPs) participated in the study. Factors contributing to breast cancer (non) disclosure were explored. Data were analysed using a thematic approach.
The analysis indicated that most of the women and family members were very reticent about breast cancer disclosure and were secretive with distant relatives and wider social networks. Whilst remaining silent about their cancer diagnosis helped women protect their identities, prevented spiritual attack, and bad advice, the need for emotional and financial support for cancer treatment triggered disclosure to close family, friends, and pastors. Some women were discouraged from persevering with conventional treatment following disclosure to their close relatives.
Breast cancer stigma and fears around disclosure hindered women from disclosing to individuals in their social networks. Women disclosed to their close relatives for support, but this was not always safe. Health care professionals are well placed to explore women's concerns and facilitate disclosure within safe spaces to enhance engagement with breast cancer care services.
尽管有理论支持认为积极的健康结果与向社交网络披露癌症有关，但来自加纳等不公开谈论癌症的国家/地区的女性可能会对乳腺癌披露有所担忧。女性可能无法分享她们关于诊断的经历，这可能会使她们无法获得支持。本研究旨在了解加纳乳腺癌女性对促成（不）披露的因素的看法。
本研究基于一项人种学研究的次要发现，该研究采用了参与式观察和半结构化面对面访谈。该研究在加纳南部一所教学医院的乳房诊所进行。16 名被诊断患有乳腺癌（最高 3 期）的女性；这些女性提名的 5 名亲属和 10 名医疗保健专业人员（HCP）参加了研究。探讨了乳腺癌（不）披露的因素。使用主题分析方法分析数据。
分析表明，大多数女性和家庭成员对乳腺癌披露非常保守，对远亲和更广泛的社交网络保持沉默。尽管对癌症诊断保持沉默有助于女性保护自己的身份，防止精神攻击和不良建议，但对癌症治疗的情感和经济支持的需求促使她们向亲密的家人、朋友和牧师透露病情。一些女性在向亲密亲属透露病情后，被劝阻不要坚持常规治疗。
乳腺癌耻辱感和对披露的恐惧阻碍了女性向社交网络中的个人披露。女性向亲密的亲戚透露病情以获得支持，但这并不总是安全的。医疗保健专业人员有很好的机会探讨女性的担忧，并在安全的环境中促进披露，以加强参与乳腺癌护理服务。
