An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

Lund-Nielsen, Betina; Midtgaard, Julie; Rørth, Mikael; Gottrup, Finn; Adamsen, Lis

doi:10.1097/ncc.0b013e3182025020

Cited by 41 publications

(35 citation statements)

References 30 publications

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“…They may delay seeking help and try to hide the reality of the cancer, which highlights the huge impact and shame associated with such a wound on an intimate part of the body, which is deeply significant for sexuality and feminitiy (Boon, et al, 2000). Those with malignant fungating wounds experience may problems such as excessive exudate and leakage, unpleasant odour from the wound, and the fear of being diagnosed with cancer, which may lead to delay in seeing medical help (Lund-Nielsen, et al, 2011).…”

mentioning

confidence: 99%

Finding the right kind of support: A study of carers of those with a primary malignant brain tumour

Arber

Hutson

Vries

et al. 2013

European Journal of Oncology Nursing

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mentioning

confidence: 99%

Finding the right kind of support: A study of carers of those with a primary malignant brain tumour

Arber

Hutson

Vries

et al. 2013

European Journal of Oncology Nursing

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“…[5][6][7] Even individuals with major health problems 4,8,9 or who are experiencing symptoms [10][11][12] avoid seeking medical care. For example, in one study, 17% of patients diagnosed with rectal tumors reported that they waited a year or more to seek medical consultation after noticing symptoms, with some waiting up to five years.…”

Section: Introductionmentioning

confidence: 99%

“…12 Avoiding medical care may result in late detection of disease, reduced survival, and potentially preventable human suffering. 1,8,13,14 In the present study, we sought to understand why people avoid seeking medical care. Avoidance of medical care has been defined as "keeping away from something [in a medical context] that is thought to cause mental or physical distress."…”

Section: Introductionmentioning

confidence: 99%

“…Avoidance of medical care has been defined as "keeping away from something [in a medical context] that is thought to cause mental or physical distress." 8 Avoidance can also occur as a result of barriers, which can be defined as factors that limit access to or ease of obtaining quality health care (e.g., financial concerns, time constraints). 1,15 Avoidance of medical care can occur at any point on the disease continuum, including preventing and detecting asymptomatic disease, noticing symptoms and interpreting their significance, seeking care after determining a potential need, and complying with recommended treatment.…”

Section: Introductionmentioning

confidence: 99%

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Why do People Avoid Medical Care? A Qualitative Study Using National Data

2014

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BACKGROUND: Many studies have examined barriers to health care utilization, with the majority conducted in the context of specific populations and diseases. Less research has focused on why people avoid seeking medical care, even when they suspect they should go. OBJECTIVE: The purpose of the study was to present a comprehensive description and conceptual categorization of reasons people avoid medical care. DESIGN: Data were collected as part of the 2008 Health Information National Trends Survey, a cross-sectional national survey. PARTICIPANTS: Participant-generated reasons for avoiding medical care were provided by 1,369 participants (40% male; M age =48.9; 75.1% non-Hispanic white, 7.4% non-Hispanic black, 8.5% Hispanic or Latino/ a). MAIN MEASURES: Participants first indicated their level of agreement with three specific reasons for avoiding medical care; these data are reported elsewhere. We report responses to a follow-up question in which participants identified other reasons they avoid seeking medical care. Reasons were coded using a general inductive approach. KEY RESULTS: Three main categories of reasons for avoiding medical care were identified. First, over one-third of participants (33.3% of 1,369) reported unfavorable evaluations of seeking medical care, such as factors related to physicians, health care organizations, and affective concerns. Second, a subset of participants reported low perceived need to seek medical care (12.2%), often because they expected their illness or symptoms to improve over time (4.0%). Third, many participants reported traditional barriers to medical care (58.4%), such as high cost (24.1%), no health insurance (8.3%), and time constraints (15.6%). We developed a conceptual model of medical care avoidance based on these results. CONCLUSIONS: Reasons for avoiding medical care were nuanced and highly varied. Understanding why people do not make it through the clinic door is critical to extending the reach and effectiveness of patient care, and these data point to new directions for research and strategies to reduce avoidance.

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“…However, it should be noted that a reduction in wound odor had positive patient outcomes, including reduction in social isolation, increase in appetite, and improved body image. 9,[34][35][36] The results of this review demonstrate that CAM products may have the potential to be used as an alternative or complimentary topical therapy to manage odor from MFWs. For instance, if manufactured odor-adsorbing or odor-controlling advanced wound dressings or pharmaceutical agents are not available, the use of CAM like unused green tea teabags in the dressing of an MFW provides a culturally acceptable, cost-effective option for containment of wound odor.…”

Section: Discussionmentioning

confidence: 99%

Complementary and alternative therapies for management of odor in malignant fungating wounds: a critical review

Gethin¹,

McIntosh²,

Probst³

2016

CWCMR

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Malignant fungating wounds (MFWs) affect an estimated 5%-10% of all people with cancer. They have a profound effect on the individual, and their associated symptoms such as bleeding, odor, exudate, and pain cause much distress, anxiety, and social isolation. Odor is cited by patients and clinicians as the worst aspect of such wounds. Strategies to manage odor at the wound site include the use of complementary and alternative therapies. This review aimed to synthesize the current evidence for the use of complementary and alternative therapies in the management of odor in MFWs. No restrictions on date, language, or care setting were applied. Nine databases were searched yielding four papers meeting our criteria. Of the four papers, one was a randomized controlled trial (RCT), and three were case studies. Two papers investigated the use of green tea teabags as a secondary dressing, while others used essential oils either combined with a cream applied directly to the wound or as a secondary dressing. In an RCT, green tea was used as a solution to cleanse the wound followed by the application of green tea teabag as a secondary dressing versus metronidazole powder for the management of odor over 7 days. All patients reported a reduction in odor and physical discomfort, and an improvement in social interaction and appetite, but the difference between groups was not statistically significant. The case studies all reported an improvement in odor management. The use of complementary and alternative therapies in the management of MFW-associated malodor is not supported by evidence from RCTs. Green tea may have potential as a secondary dressing to manage odor. Further research in this area is warranted.

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An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

Abstract: In a preventive perspective, it seems advantageous to bring into focus the health of primary and bereaved caregivers, thereby potentially reducing patient delay and ultimately improving survival.

Cited by 41 publications

References 30 publications

Finding the right kind of support: A study of carers of those with a primary malignant brain tumour

Finding the right kind of support: A study of carers of those with a primary malignant brain tumour

Why do People Avoid Medical Care? A Qualitative Study Using National Data

Complementary and alternative therapies for management of odor in malignant fungating wounds: a critical review

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