Mohamed Rehna Chaneparambil, George Leyanna Susan, Tomy Chitra
Department of Public Health, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India.
Department of Community Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India.
J Family Med Prim Care. 2025 Feb;14(2):609-616. doi: 10.4103/jfmpc.jfmpc_142_24. Epub 2025 Feb 21.
Breast Cancer is the commonest cancer among women both in developed and developing world. Exploring the reasons involved in 'no-show' at the health facility, which is also a teaching hospital, after being diagnosed with breast cancer can aid as a problem identifier, act as an add-on for continuous quality improvement in healthcare and open avenue of understanding about participation that women have in decision-making. This study aims to explore the reasons for 'no-show' after diagnosis of breast cancer in a teaching hospital.
A hospital-based cancer registry was used to extract the number of patients from the medical records department (MRD) who were diagnosed with breast cancer but did not show up for the treatment offered. Qualitative study method of in-depth interview was employed to understand the reasons for not following up after diagnosis. Interviews were audio taped, transcribed verbatim, analyzed for thematic contents using the standard content analysis framework.
Personal, familial, social, and hospital-related factors were involved in not following up in the health facility. The major themes were financial difficulties, general inconvenience, others' decisions, alternative therapy, acclaimed oncologists, and awful occurrences, which were categorized under three heads as perceived barriers to continuing treatment in the health facility of study, perceived benefits of treatment in other facilities, and influence of family, friends, and society on decision-making.
The study throws light on the multitude of reasons behind 'no-show' behavior among patients with breast cancer from the facility where the diagnosis was made, highlighting the requirement for a more patient-centred approach that considers financial, social, and psychological factors in healthcare delivery. Addressing these barriers could significantly improve treatment adherence and outcomes in breast cancer care.
乳腺癌是发达国家和发展中国家女性中最常见的癌症。探究在这家同时也是教学医院的医疗机构被诊断出患有乳腺癌后未就诊的原因，有助于识别问题、助力医疗保健持续质量改进，并开辟理解女性在决策中参与情况的途径。本研究旨在探究一家教学医院中乳腺癌患者诊断后未就诊的原因。
利用医院癌症登记处从病历科提取被诊断患有乳腺癌但未前来接受所提供治疗的患者数量。采用深入访谈的定性研究方法来了解诊断后未跟进治疗的原因。访谈进行录音，逐字转录，使用标准内容分析框架对主题内容进行分析。
个人、家庭、社会和医院相关因素均与未在该医疗机构跟进治疗有关。主要主题包括经济困难、普遍不便、他人决策、替代疗法、知名肿瘤学家以及可怕事件，这些被归为三类：在本研究医疗机构继续治疗的感知障碍、在其他机构治疗的感知益处以及家庭、朋友和社会对决策的影响。
该研究揭示了乳腺癌患者在确诊机构出现未就诊行为背后的众多原因，凸显了在医疗服务中采用更以患者为中心的方法的必要性，这种方法应考虑到财务、社会和心理因素。克服这些障碍可显著提高乳腺癌护理中的治疗依从性和治疗效果。
