Dominic Pascal Mkaka, Iseselo Masunga K, Athanas Raymond
Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Bioethics and Health Professionalism, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLOS Glob Public Health. 2024 Nov 7;4(11):e0003366. doi: 10.1371/journal.pgph.0003366. eCollection 2024.
Breast cancer is a major public health problem in both developed and developing countries and has become the second leading cause of death among women worldwide. The mortality may be related to delayed or inappropriate treatment decision-making among the diagnosed patients. Decision-making is an important determinant for successful treatment for patients diagnosed with breast cancer. In Tanzania, there is a lack of information in the context of facilitators and barriers to treatment decision-making after a breast cancer diagnosis. This study aimed to explore facilitators and barriers to treatment decision-making among cancer patients in Tanzania.
A descriptive qualitative design was employed to explore the facilitators and barriers to treatment decision-making at Ocean Road Cancer Institute in Dar es Salaam. A purposive sampling technique was used to recruit fourteen female patients diagnosed with breast cancer. Data were collected through in-depth, semi-structured interviews, which were audio-recorded. A thematic approach was used to analyze the data.
Two major themes emerged from the study findings, namely; facilitators to treatment decision-making such as patient understanding of treatment information, and healthcare providers' support. Barriers to treatment decision-making include the cost of treatment, uncertainty about cancer treatment, and religious healing.
This study found that practising decision-making for hospital treatment remains a challenge for patients diagnosed with breast cancer. Patients' understanding of treatment information and healthcare providers' support are the main tools that can facilitate decision-making. Sensitization activities on breast cancer treatment in the community and coverage of insurance should be advocated to promote decision-making for hospital treatment.
乳腺癌在发达国家和发展中国家都是一个重大的公共卫生问题，已成为全球女性第二大死因。死亡率可能与确诊患者治疗决策的延迟或不当有关。决策是乳腺癌确诊患者成功治疗的重要决定因素。在坦桑尼亚，缺乏关于乳腺癌诊断后治疗决策的促进因素和障碍方面的信息。本研究旨在探讨坦桑尼亚癌症患者治疗决策的促进因素和障碍。
采用描述性定性设计，以探究达累斯萨拉姆海洋路癌症研究所治疗决策的促进因素和障碍。采用目的抽样技术招募了14名被诊断患有乳腺癌的女性患者。通过深入的半结构化访谈收集数据，并进行录音。采用主题分析法对数据进行分析。
研究结果出现了两个主要主题，即治疗决策的促进因素，如患者对治疗信息的理解和医疗服务提供者的支持。治疗决策的障碍包括治疗费用、癌症治疗的不确定性和宗教疗法。
本研究发现，对于乳腺癌确诊患者来说，做出住院治疗决策仍然是一项挑战。患者对治疗信息的理解和医疗服务提供者的支持是促进决策的主要工具。应倡导在社区开展乳腺癌治疗宣传活动并扩大保险覆盖范围，以促进住院治疗决策。
