See the published version of this article at BMC Cancer.
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Research article
ANITA ESEENAM AGBEKO
Komfo Anokye Teaching Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3505-3052
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
BACKGROUND: About 85% of breast cancer patients attending Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. In spite of great investments into the early diagnosis and management of breast cancer, late presentation persists and poses a barrier to realising the possible benefits of the gains made in breast cancer management. This study assessed the symptom appraisal and medical health seeking behaviour of women with either locally advanced or metastatic breast cancer attending breast clinic at KATH
METHOD: In-depth interviews of women presenting with clinical stage III/IV breast cancer were conducted to explore the women’s care seeking pathways after symptom identification until arrival at KATH from May 2015 to March 2016. Thematic data analysis was conducted using the Andersen behavioural model for health service use.
RESULTS: Fifteen women aged 24 – 79 years were interviewed. The time from symptom identification to reporting to KATH was 4 - 24 months. The initial symptom was a breast lump or breast swelling which all the women identified themselves. These were initially appraised as not serious because most importantly, they did not interfere with their daily function. Symptom progression such as prevented them from undertaking their usual economic, social and family function triggered seeking care from health facilities. The availability of money to pay for care and diagnostic investigations influenced the time taken to navigate the referral pathway. While the women initially deferred healthcare for reasons related to their ability to perform economic, family and social roles, ultimately, aggressively pursuing healthcare was also for the same economic, family and social reasons or goals.
CONCLUSION: Deciding to seek care and pursue treatment for breast cancer symptoms may be much more complicated than it appears. Economic, family and social function significantly drive the health seeking process both at the personal and health facility phases of health seeking. Breast cancer education messages must be adapted to incorporate these functional goals and their influence on symptom appraisal and decision making to seek help and not just focus on the breast symptom as an isolated entity.
Keywords
advanced breast cancer, health seeking behaviour, care seeking pathway, delay
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Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 15 Aug, 2020
Published
On 19 Oct, 2020
Published
On 19 Oct, 2020
No community comments so far
Editorial decision: Accept
On 12 Oct, 2020
Review #2 received
Received 09 Oct, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Reviewer #1 agreed
On 28 Aug, 2020
Review #1 received
Received 28 Aug, 2020
Editor assigned
On 12 Aug, 2020
Reviewers invited
Invitations sent on 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Review #2 received
Received 27 Jul, 2020
Editorial decision: Minor revision
On 27 Jul, 2020
Review #1 received
Received 09 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
Reviewers invited
Invitations sent on 01 Jul, 2020
Editor assigned
On 28 Jun, 2020
Submission checks complete
On 27 Jun, 2020
Editor invited
On 27 Jun, 2020
First submitted
On 26 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
ANITA ESEENAM AGBEKO
Komfo Anokye Teaching Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3505-3052
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 15 Aug, 2020
Published
On 19 Oct, 2020
Published
On 19 Oct, 2020
No community comments so far
Editorial decision: Accept
On 12 Oct, 2020
Review #2 received
Received 09 Oct, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Reviewer #1 agreed
On 28 Aug, 2020
Review #1 received
Received 28 Aug, 2020
Editor assigned
On 12 Aug, 2020
Reviewers invited
Invitations sent on 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
No comments provided
Review #2 received
Received 27 Jul, 2020
Editorial decision: Minor revision
On 27 Jul, 2020
Review #1 received
Received 09 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
Reviewers invited
Invitations sent on 01 Jul, 2020
Editor assigned
On 28 Jun, 2020
Submission checks complete
On 27 Jun, 2020
Editor invited
On 27 Jun, 2020
First submitted
On 26 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
BACKGROUND: About 85% of breast cancer patients attending Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. In spite of great investments into the early diagnosis and management of breast cancer, late presentation persists and poses a barrier to realising the possible benefits of the gains made in breast cancer management. This study assessed the symptom appraisal and medical health seeking behaviour of women with either locally advanced or metastatic breast cancer attending breast clinic at KATH
METHOD: In-depth interviews of women presenting with clinical stage III/IV breast cancer were conducted to explore the women’s care seeking pathways after symptom identification until arrival at KATH from May 2015 to March 2016. Thematic data analysis was conducted using the Andersen behavioural model for health service use.
RESULTS: Fifteen women aged 24 – 79 years were interviewed. The time from symptom identification to reporting to KATH was 4 - 24 months. The initial symptom was a breast lump or breast swelling which all the women identified themselves. These were initially appraised as not serious because most importantly, they did not interfere with their daily function. Symptom progression such as prevented them from undertaking their usual economic, social and family function triggered seeking care from health facilities. The availability of money to pay for care and diagnostic investigations influenced the time taken to navigate the referral pathway. While the women initially deferred healthcare for reasons related to their ability to perform economic, family and social roles, ultimately, aggressively pursuing healthcare was also for the same economic, family and social reasons or goals.
CONCLUSION: Deciding to seek care and pursue treatment for breast cancer symptoms may be much more complicated than it appears. Economic, family and social function significantly drive the health seeking process both at the personal and health facility phases of health seeking. Breast cancer education messages must be adapted to incorporate these functional goals and their influence on symptom appraisal and decision making to seek help and not just focus on the breast symptom as an isolated entity.
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