Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda

Meacham, Elizabeth; Orem, Jackson; Nakigudde, Gertrude; Zujewski, Jo Anne; Rao, Deepa

doi:10.1002/pon.4215

Cited by 85 publications

(93 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…VHTs and dispensary staff should be educated to recognize the signs and symptoms of breast cancer, to know the appropriate level of care for patient referral (currently level 5 or 6 until capacity is built at lower levels of the health system), and to deliver culturally appropriate health messages regarding breast cancer awareness to women 13‐16 . These efforts can be integrated into established systems; for example, prior research demonstrated the success of educational strategies in Uganda for improving outcomes for the management of infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer early detection and diagnostic capacity in Uganda

Giglou

Segel

Orem

et al. 2020

Cancer

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Greater than 80% of women presenting for breast cancer treatment in Uganda have late-stage disease, which is attributable to a dysfunctional referral system and a lack of recognition of the early signs and symptoms among primary health care providers, and compounded by the poor infrastructure and inadequate human capacity. Improving the breast health care system requires a systemic approach beginning with situational analysis to identify systematic gaps that prevent sustainable improvements in outcome. METHODS:The authors performed a situational analysis of the breast health care system using methods developed by the Breast Health Global Initiative. Based on their findings, they developed a series of recommendations for strengthening the health system for the early diagnosis of breast cancer based on clinical detection, referral, tissue sampling, and diagnosis. RESULTS: Deficits in the recognition of breast cancer signs and symptoms, the underuse of clinical breast examination as a diagnostic and/or screening tool, the centralization of diagnostic tests (radiology and pathology), reliance on excisional biopsies rather than needle biopsies, and a lack of trained professionals and knowledge of the referral system all contribute to significant health system delays. CONCLUSIONS: To strengthen referral networks and improve the early diagnosis of breast cancer in Uganda, national referral hospitals should provide educational programs to primary health care providers in community health centers (CHCs), at which the majority of women first present with symptoms. At secondary district-level facilities in which imaging and tissue sampling can be performed, the capacity for diagnostic testing could be increased through task shifting of basic interpretation (abnormal vs normal) from specialists to nonspecialists using networking technology to facilitate remote oversight from specialists at the national referral hospitals. Cancer 2020;126:2469-2480.

show abstract

Section: Discussionmentioning

confidence: 99%

Breast cancer early detection and diagnostic capacity in Uganda

Giglou

Segel

Orem

et al. 2020

Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…The largest study conducted in Ghana identified low level of education and delayed care‐seeking behavior as risk factors for presenting with tumors larger than 5 cm . Similarly, other smaller studies have identified limited knowledge , stigma associated with a cancer diagnosis, lack of social and financial support, and seeking alternative treatment from traditional healers as risk factors for delayed presentation . Although the current literature identifies several factors associated with delayed breast cancer presentation and the need for breast education as a cornerstone for increasing awareness, more research is needed to understand the information gaps specific to the sociocultural setting.…”

Section: Introductionmentioning

confidence: 97%

Fear of Mastectomy Associated with Delayed Breast Cancer Presentation Among Ghanaian Women

2018

View full text Add to dashboard Cite

Most women in Ghana present with advanced-stage disease. The aim of this study was to characterize sociocultural factors associated with delayed presentation. Although several quantitative studies have been conducted on delays in presentation in sub-Saharan Africa (SSA), this study is one of the few to identify fear of mastectomy as a reason for delayed presentation. Anecdotal data from current clinical experiences in SSA suggest that this is still an issue that has not been adequately reported and addressed in most SSA countries. The research results presented here will hopefully guide health providers and national organizations in designing breast cancer education programs in Ghana and other parts of SSA.

show abstract

“…Stigma not only increases the potential harm of the disease but also leads to unhealthy psychological and social statuses among patients. Because of stigma, some people avoid social interactions and even isolate themselves completely, thereby negatively affecting their clinical encounters, the effects of therapy, their marriages, and other aspects of their life . Stigmatized patients might blame and criticize themselves along with facing discriminated against by others; consequently, these patients may feel ashamed, and their mental states might worsen, thereby reinforcing a vicious cycle …”

Section: Introductionmentioning

confidence: 99%

“…Because of stigma, some people avoid social interactions and even isolate themselves completely, thereby negatively affecting their clinical encounters, the effects of therapy, their marriages, and other aspects of their life. 5,6 Stigmatized patients might blame and criticize themselves along with facing discriminated against by others; consequently, these patients may feel ashamed, and their mental states might worsen, thereby reinforcing a vicious cycle. 7,8 One type of subjective feeling, coping self-efficacy, evaluates the coping strategies and methods a person uses when they face challenges.…”

mentioning

confidence: 99%

Stigma and its influencing factors among Chinese patients with stoma

et al. 2018

View full text Add to dashboard Cite

Medical staff members should pay more attention to stigma in stoma patients. Coping self-efficacy, family members' acceptance of the stoma, and participation in activities with other stoma patients are influencing factors that protect these patients against stigma, whereas body image loss and stool leakage place them at higher risk for stigma. Interventions aimed at improving protective factors and decreasing risk factors should be considered to reduce the level of stigma in patients with stoma.

show abstract

Exploring stigma as a barrier to cancer service engagement with breast cancer survivors in Kampala, Uganda

Abstract: Objective To understand the role of stigma in the delay of cancer service engagement by women with breast cancer in Kampala, Uganda.

Cited by 85 publications

References 12 publications

Breast cancer early detection and diagnostic capacity in Uganda

Breast cancer early detection and diagnostic capacity in Uganda

Fear of Mastectomy Associated with Delayed Breast Cancer Presentation Among Ghanaian Women

Stigma and its influencing factors among Chinese patients with stoma

Contact Info

Product

Resources

About