RESUMEN
Breast cancer is the most prevalent malignant neoplasm among women. Its treatment comprises different strategies. Telehealth can ensure continuity of care in distant locations. This study aimed to synthesize qualitative evidence of women's experiences with telehealth during the treatment and follow-up of breast cancer. We performed a qualitative systematic review and meta-synthesis. The databases included in the search were: Pubmed, EMBASE, CINAHAL, and Web of Science. The search combined the terms: breast cancer, telemedicine, telehealth, and qualitative study. The studies included were: qualitative design and mixed methods studies with qualitative components. The COREQ Checklist assisted in assessing the quality of included studies and an adaptation of thematic analysis for the qualitative meta-synthesis. We included twelve articles in the review. In the meta-synthesis, 3 themes emerged. (1) Structure: simple design and space to obtain information but in need of adjustments. (2) Usability: about the benefits and limitations of telehealth. (3) Interaction with health professionals. Telehealth is an accepted strategy for the clinical care of women with breast cancer. Patients identified the need for improvements in structure, usability, and interaction. PROTOCOL REGISTRATION: PROSPERO registration number CRD42021228326, registered 06/02/2021.
Asunto(s)
Neoplasias de la Mama , Telemedicina , Femenino , Humanos , Neoplasias de la Mama/terapia , Personal de Salud , Investigación Cualitativa , Telemedicina/métodosRESUMEN
BACKGROUND: Advanced stage and high mortality are characteristics of cervical cancer in developing countries. Comprehension of the diagnosis itinerary is one of the main strategies to control the disease impact. OBJECTIVES: To identify reasons for the delay in diagnosing symptomatic cervical cancer according to the patient's perspectives reported in qualitative studies. We searched four databases (PubMed, Embase, CINAHL, and Web of Science). SELECTION CRITERIA: We included qualitative studies of women with advanced cervical cancer that explored their experiences before treatment. We excluded unoriginal, non-qualitative, and duplicated studies. DATA COLLECTION AND ANALYSIS: We selected 39 articles for a full-text reading and included 15 in the present review. We chose the Consolidated Criteria for Reporting Qualitative Research (COREQ) for quality assessment and The Model of Pathways to Treatment to guide the codifying process. MAIN RESULTS: Four main themes emerged from the synthesis: (1) Health-seeking motivators; (2) Obstacles to seeking medical care; (3) Diagnosis delay; and (4) Coping with the disease. These themes were derived from patients' personal knowledge and beliefs, social relationships, socioeconomic status, and healthcare system characteristics. CONCLUSIONS: Individual behavior, social factors, and healthcare organization contribute to the delay in diagnosing advanced cervical cancer.