Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
BMJ Open. 2024 Aug 17;14(8):e081839. doi: 10.1136/bmjopen-2023-081839.
Breast cancer is the most common cancer among women all around the world. Today, in addition to factors including hormones and genetics that are involved in the occurrence of breast cancer, special attention is paid to the role of social and non-medical determinants of health. This study aims to explore the perception of Social Determinants of Health (SDH) in women with breast cancer.
Qualitative study design with a conventional thematic analysis approach.
The study was conducted in Tehran, Iran, between December 2021 and February 2023.
19 women with breast cancer were selected through purposeful and snowball sampling with maximum variation. Sampling continued until data saturation was reached.
The study categorised the extracted codes from interviews into three main categories and 12 subcategories related to SDH in women with breast cancer.
The study identified factors such as personal and family health records, health behaviours and lifestyles and medical screening and follow-up as key themes in the perception of SDH among women with breast cancer. The main categories were also categorised into 12 subcategories, 'including family history', 'environmental factors', 'hormonal and medicinal changes', 'metaphysical factors', 'traditional medicine-related factors', 'stress', 'body weight', 'physical activity', 'nutrition', 'smoking and tobacco use', 'screening', 'self-examination' and 'barriers to medical follow-up'. 'Near the telecommunications tower', 'Improper use of supplements', 'Being subjected to the evil eye regularly', 'Eating cold nature foods', 'Breast weight' and 'Being ashamed of the doctor' were some examples of the codes.
Participants identified a number of environmental, personal and cultural factors as contributing to the disease. Woman's screening behaviours were influenced by factors such as fear of disease and death, disbelief in getting sick and shame, depending on cultural context. The study suggests the need for further research to explore the impact of these factors on screening behaviours and outcomes in different cultural contexts.
乳腺癌是全世界女性最常见的癌症。如今，除了与乳腺癌发生相关的激素和遗传等因素外，人们特别关注社会和非医疗健康决定因素的作用。本研究旨在探讨乳腺癌患者对社会健康决定因素（SDH）的认知。
采用常规主题分析方法的定性研究设计。
该研究于 2021 年 12 月至 2023 年 2 月在伊朗德黑兰进行。
通过有目的和滚雪球抽样，选择了 19 名乳腺癌女性患者，采用最大变异抽样。采样一直持续到数据饱和为止。
该研究将访谈中提取的代码分为三个主要类别和 12 个子类别，与乳腺癌患者的 SDH 相关。
该研究确定了个人和家庭健康记录、健康行为和生活方式以及医疗筛查和随访等因素，这些因素是乳腺癌患者对 SDH 认知的关键主题。主要类别也分为 12 个子类别，包括“家族病史”、“环境因素”、“荷尔蒙和药物变化”、“形而上学因素”、“传统医学相关因素”、“压力”、“体重”、“身体活动”、“营养”、“吸烟和烟草使用”、“筛查”、“自我检查”和“医疗随访障碍”。一些代码示例包括“靠近电信塔”、“不当使用补品”、“定期受到邪眼影响”、“吃冷性食物”、“乳房重量”和“对医生感到羞耻”。
参与者确定了一些环境、个人和文化因素是导致该疾病的原因。女性的筛查行为受到诸如对疾病和死亡的恐惧、对患病的不相信和羞耻感等因素的影响，这取决于文化背景。该研究表明，需要进一步研究来探索这些因素对不同文化背景下筛查行为和结果的影响。
