Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals’ perspectives and strategies

Brown, Ottilia; Goliath, Veonna; Rooyen, Dalena van; Aldous, Colleen; Marais, Leonard Charles

doi:10.4102/hsag.v23i0.1095

Cited by 9 publications

(20 citation statements)

References 35 publications

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“…Individualism underpins the Western approach in medical practice but in Africa, the collectivist approach is dominant. 24 Individualism places emphasis on the individual goals and rights whereas collectivism focuses on the group. In the collectivist societies, people belong to a group and are rewarded for their loyalty.…”

Section: Discussionmentioning

confidence: 99%

“…In the collectivist societies, people belong to a group and are rewarded for their loyalty. 24 The beliefs of the community and society influences medical decision making. 24 Taking into consideration community beliefs may provide insight into the conceptualisation of adolescent pregnancy and motherhood and how access to healthcare services can be affected.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers</p>

Govender

Taylor

Naidoo

2020

JMDH

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p>Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers</p>

Govender

Taylor

Naidoo

2020

JMDH

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“…Prognostic information should, however, be provided when there are requests or expectations that are inconsistent with clinical judgement, 19 as in this case when patients go home to consult with decision-makers and often delay returning to the hospital. 7 Furthermore, discussing prognosis facilitates treatment decision-making. 19,33 Patient knowledge of prognosis has been shown to play a significant role in making appropriate treatment choices.…”

Section: Discussionmentioning

confidence: 99%

“…Zulu patients often insisted on going home to consult with the elders and perform rituals after being informed about treatment options, especially when this entailed amputation. 7 Participants were concerned that when patients went home, they would be preoccupied with being told about a poor prognosis instead of focusing on consulting the decision-makers regarding proposed treatment options.…”

Section: Don't Feel Comfortable Talking About Prognosis … I Find Prmentioning

confidence: 99%

“…The Zulu people are indigenous and place great value on traditional belief systems and often prefer a family-centred model of medical decisionmaking 5 especially when the proposed surgical treatment option is amputation. 7 A 2012 study revealed that 66.67% of the patients presenting at the study site with osteosarcoma between 2009 and 2011 already had metastatic disease. 8 Healthcare professionals (HCPs) therefore find communicating prognosis to be especially challenging in this cross-cultural context as patients present late for treatment and tend to practise systems of healing and decisionmaking that are different from the Western medical system.…”

Section: Introductionmentioning

confidence: 98%

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Communicating about prognosis with regard to osteosarcoma in a South African cross-cultural clinical setting: strategies and challenges

et al. 2019

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Background: Effective prognostic communication with patients is a prerequisite for treatment decision-making, yet it is a difficult task to manage with confidence. This paper explores the strategies used and challenges faced when communicating about prognosis in a cross-cultural clinical setting. Patients and methods: We used a qualitative exploratory descriptive contextual design and gathered data using focus group interviews with healthcare professionals. Twenty-three healthcare professionals participated in three focus groups. We analysed the data thematically. Guba's Model of Trustworthiness was used to ensure rigour. Results: Our findings revealed strategies for communicating about prognosis. Assessing patient emotions and knowledge, and providing patients with clear prognostic information, emerged as prominent strategies. Healthcare professionals proposed communicating frankly about the consequences of not treating osteosarcoma, treatment limitations, metastases and poor prognoses. They also suggested presenting prognostic information in a staged approach, normalising death, and not specifying life expectancy. In addition, informing patients that a palliative amputation would help with pain management emerged as a strategy for instilling hope. Various patient, provider and disease factors were identified as challenges when discussing prognosis. Conclusions: Deviations from Western research findings emphasised the need for studies exploring prognostic communication in cross-cultural encounters. Our study highlighted the need for creative and thoughtful approaches to communicating sensitive information in cross-cultural clinical settings.

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Factors influencing treatment decision‐making for cancer patients in low‐ and middle‐income countries: A scoping review

et al. 2023

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PurposeIn this scoping review, we evaluated existing literature related to factors influencing treatment decision‐making for patients diagnosed with cancer in low‐ and middle‐income countries, noting factors that influence decisions to pursue treatment with curative versus non‐curative intent. We identified an existing framework for adult cancer developed in a high‐income country (HIC) context and described similar and novel factors relevant to low‐and middle‐income country settings.MethodsWe used scoping review methodology to identify and synthesize existing literature on factors influencing decision‐making for pediatric and adult cancer in these settings. Articles were identified through an advanced Boolean search across six databases, inclusive of all article types from inception through July 2022.ResultsSeventy‐nine articles were identified from 22 countries across six regions, primarily reporting the experiences of lower‐middle and upper‐middle‐income countries. Included articles largely represented original research (54%), adult cancer populations (61%), and studied patients as the targeted population (51%). More than a quarter of articles focused exclusively on breast cancer (28%). Approximately 30% described factors that influenced decisions to choose between therapies with curative versus non‐curative intent. Of 56 reported factors, 22 novel factors were identified. Socioeconomic status, reimbursement policies/cost of treatment, and treatment and supportive care were the most commonly described factors.ConclusionsThis scoping review expanded upon previously described factors that influence cancer treatment decision‐making in HICs, broadening knowledge to include perspectives of low‐ and middle‐income countries. While global commonalities exist, certain variables influence treatment choices differently or uniquely in different settings. Treatment regimens should further be tailored to local environments with consideration of contextual factors and accessible resources that often impact decision‐making.

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Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals’ perspectives and strategies

Cited by 9 publications

References 35 publications

<p>Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers</p>

<p>Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers</p>

Communicating about prognosis with regard to osteosarcoma in a South African cross-cultural clinical setting: strategies and challenges

Factors influencing treatment decision‐making for cancer patients in low‐ and middle‐income countries: A scoping review

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