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坦桑尼亚姆万扎布甘多肿瘤诊所宫颈癌患者的就医行为及影响治疗依从性的因素:一项质性现象学研究

Healthcare-seeking behaviors and factors influencing non-adherence among cervical cancer patients attending Bugando Oncology Clinic in Mwanza, Tanzania: A qualitative Phenomenological study.

作者信息

Kidaya Bashari Nuru, Mwanga Joseph Rogathe, Muhini Oscar Ottoman, Mwaisungu Halima Mdemu, Juma Elisha Mabula, Buremo Vivian Elikana

机构信息

Department of Oncology, Bugando Medical Centre, Mwanza, Tanzania.

Department of Epidemiology, Biostatistics & Behavioral Sciences, School of Public Health, Catholic University of Health, and Allied Sciences (CUHAS) Mwanza, Tanzania.

出版信息

PLoS One. 2025 Mar 26;20(3):e0317609. doi: 10.1371/journal.pone.0317609. eCollection 2025.

Abstract

BACKGROUND

In low- and middle-income countries, particularly in Tanzania, most patients with cervical cancer present with advanced-stage disease and exhibit non-adherence which results in increased numbers of patients with cancer-related deaths. The current study explores the health-seeking behavior of cervical cancer patients and the factors that influence their non-adherence to cancer care.

OBJECTIVE

To explore the healthcare-seeking behaviors and identify factors influencing non-adherence among cervical cancer patients attending Bugando Medical Center's Oncology Clinic in Mwanza, Tanzania.

METHODS

A qualitative phenomenological design was adopted to explore the lived experiences of 15 households with non-adherent cervical cancer patients, after obtaining patients' information from the chemo radiation treatment registries of Bugando Oncology Clinic in Mwanza, Tanzania. Data were generated through in-depth interviews with patients, and NVivo 12 qualitative computer software was used to aid analysis. Thematic content analysis was conducted to uncover underlying meanings and patterns in the data, providing valuable insights into the phenomena under investigation.

FINDINGS

The study revealed poor adherence to treatment-seeking by most of the study informants in the form of delayed health-seeking at nearby health facilities. The limited capacity for correct cervical cancer diagnosis also pushed some of the informants to turn to self-medication including traditional remedies. The findings revealed delayed healthcare-seeking behavior and poor adherence to most of the study participants seeking medical care at nearby health facilities with limited capacity for correct cervical cancer diagnosis. Some turned to self-medications including traditional remedies. Financial constraints emerged as a major obstacle, affecting the affordability of treatments, transportation, and accommodation. Moreover, the malfunctioning radiotherapy machine posed a significant barrier to effective treatment. Limited comprehensive information on their condition, treatment options, and schedules further hindered adherence.

CONCLUSION

There is a need for improved access to an appropriate healthcare system and interventions to improve non-adherence to treatment of cervical cancer services, as well as increase public awareness, initiation of tools for good adherence of chemotherapy treatment and mass screening of cervical cancer risk factors and earlier diagnosis for better survival from the disease in Tanzania.

摘要

背景

在低收入和中等收入国家,尤其是坦桑尼亚,大多数宫颈癌患者就诊时已处于疾病晚期,且存在不依从性,这导致癌症相关死亡患者数量增加。本研究探讨宫颈癌患者的就医行为以及影响其不坚持癌症治疗的因素。

目的

探讨坦桑尼亚姆万扎布甘多医疗中心肿瘤诊所宫颈癌患者的就医行为,并确定影响其不依从治疗的因素。

方法

采用定性现象学设计,从坦桑尼亚姆万扎布甘多肿瘤诊所的化疗放疗治疗登记处获取患者信息后,对15户有不依从宫颈癌患者的家庭的生活经历进行探索。通过对患者进行深入访谈收集数据,并使用NVivo 12定性计算机软件辅助分析。进行主题内容分析以揭示数据中的潜在意义和模式,为所研究的现象提供有价值的见解。

结果

研究发现,大多数研究对象以在附近医疗机构延迟就医的形式表现出对寻求治疗的依从性差。正确诊断宫颈癌的能力有限也促使一些研究对象转向自我治疗,包括使用传统疗法。研究结果显示,大多数在附近医疗机构寻求医疗服务的研究参与者存在延迟就医行为和对治疗的依从性差,这些机构正确诊断宫颈癌的能力有限。一些人转向自我治疗,包括使用传统疗法。经济限制成为一个主要障碍,影响了治疗、交通和住宿的可负担性。此外,放疗机故障对有效治疗构成了重大障碍。关于病情、治疗选择和时间表的全面信息有限,进一步阻碍了依从性。

结论

在坦桑尼亚,需要改善获得适当医疗保健系统和干预措施的机会,以改善对宫颈癌治疗服务的不依从性,提高公众意识,启动有助于化疗治疗良好依从性的工具,对宫颈癌风险因素进行大规模筛查,并尽早诊断,以提高患者从该疾病中存活的几率。

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