RESUMEN
OBJECTIVE: The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. METHOD: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic of Hasan Sadikin Hospital in Bandung, Indonesia. Interviews were recorded, transcribed verbatim, and coded using qualitative software. Codes were merged into main themes that were subsequently mapped onto the study's aim. RESULTS: Eight main themes concerning reasons for delay in seeking medical help and treatment nonadherence emerged, namely: lack of awareness and knowledge, cancer beliefs, treatment beliefs, financial problems, emotional burden, severe side effects, paternalistic style of communication, and unmet information needs. CONCLUSION: This study has identified several modifiable psychosocial and cultural factors related to delay in seeking help and nonadherence to treatment in breast cancer patients. We suggest that the provision of extensive information through media campaigns, treatment decision aids, and caregiver and patient education are needed to change the illness behaviors of Indonesian breast cancer patients.
Asunto(s)
Neoplasias de la Mama/terapia , Características Culturales , Aceptación de la Atención de Salud/psicología , Cooperación del Paciente/psicología , Tiempo de Tratamiento/estadística & datos numéricos , Adulto , Anciano , Neoplasias de la Mama/psicología , Comunicación , Información de Salud al Consumidor , Femenino , Conocimientos, Actitudes y Práctica en Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Indonesia , Persona de Mediana Edad , Relaciones Médico-Paciente , Investigación Cualitativa , Factores SocioeconómicosRESUMEN
PURPOSE: The aims of this study were to assess the level of satisfaction with the information on illness and treatment among breast cancer patients, to explore its association with patients' illness perceptions and quality of life, and to provide recommendations for improvement of the information provided. METHODS: Seventy breast cancer patients at the Outpatient Surgical Oncology Clinic in Hasan Sadikin Hospital in Indonesia were recruited consecutively in a cross-sectional study design. They completed a demographic form, the Satisfaction with Cancer Information Profile, the Brief Illness Perception Questionnaire, and the World Health Organization Quality of Life. RESULTS: A considerable number of breast cancer patients (41-86 %) were dissatisfied with the amount and content of the information they received, particularly on the information about access to patient support groups and the impact of their treatment on long-term quality of life. The majority of patients were dissatisfied with the amount of written information provided. Patients who were satisfied with the type and timing of information received had stronger beliefs in personal control (ß = -0.30, p < 0.05), lesser concerns about their health condition (ß = -0.47, p < 0.01), and better understanding of their illness (ß = -0.27, p < 0.05), and were less emotionally affected by their illness (ß = -0.27, p < 0.05). In addition, the satisfied patients had a more positive perception of their general health (ß = 0.31, p < 0.05) and better psychological health condition (ß = 0.33, p < 0.05). CONCLUSIONS: Satisfaction with the information provided is associated with better health outcomes, including more positive illness perceptions. This study appears to highlight the importance of providing adequate and sufficient information that meets the needs of patients.
Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto/normas , Satisfacción del Paciente , Calidad de Vida , Adulto , Anciano , Pueblo Asiatico , Estudios Transversales , Femenino , Humanos , Indonesia , Persona de Mediana Edad , Percepción , Encuestas y CuestionariosRESUMEN
PURPOSE: This study aims to translate the Distress Thermometer (DT) into Indonesian, test its validity in Indonesian women with breast cancer and determine norm scores of the Indonesian DT for clinically relevant distress. METHODS: First, the original version of the DT was translated using a forward and backward translation procedure according to the guidelines. Next, a group of 120 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic in Hasan Sadikin Hospital in Indonesia completed a standard socio-demographic form, the DT and the Problem List, the Hospital Anxiety and Depression Scale (HADS) and the WHO Quality of Life (WHOQOL-BREF). RESULTS: Receiver operating characteristic (ROC) curve analyses identified an area under the curveâ=â0.81 when compared to the HADS cutoff score of 15. A cutoff score of 5 on the DT had the best sensitivity (0.81) and specificity (0.64). Patients who scored above this cutoff reported more problems in the practical, family, emotional, spiritual/religious and physical domains (30 out of 36 problems, p-value<0.05) than patients below the cutoff score. Patients at advanced stages of cancer experienced more emotional and physical problems. Patient's distress level was negatively correlated with overall quality of life, general health and all quality of life domains. CONCLUSIONS: The DT was found to be a valid tool for screening distress in Indonesian breast cancer patients. We recommend using a cutoff score of 5 in this population.