HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

HEALTH-SEEKING BEHAVIORS OF WOMEN WITH ADVANCED BREAST CANCER IN SOUTHWESTERN NIGERIA

Background: The survival rate of breast cancer in Nigerian women is low (56%). It has been observed in the empirical literature that Nigerian women present with advanced stages of breast cancer. The presentation of breast cancer at the advanced stages, reduces the options available to the women for the management of the illness, which had contributed to the low survival rate. Little is known about the health-seeking behaviors of women after they observed breast changes, how they interpreted and managed their breast changes and the factors they believe influence their health-seeking activities. Purpose and Objectives: The aims of the study were to explore the health-seeking behaviors of women with advanced stages of breast cancer in Southwestern Nigeria and the factors that influenced them in engaging in specific health-seeking activities from their perspectives. The advanced stages of breast cancer were defined as Stage III or stage IV breast cancer. Methods: Ethical approval to conduct the study was obtained from the University of Saskatchewan’s Behavioral Research Ethics Board and the Joint Research Committee of University of Ibadan and University College Hospital Ibadan. Using purposeful sampling techniques, 30 women who were all diagnosed with advanced stage breast cancer were recruited as the study participants. The Health Belief Model (HBM), provided the conceptual framework, and interpretive description (ID) a qualitative research approach, was used to explore the health-seeking behaviors and the factors that influenced the study participants to engage in these health-seeking behaviors. Using semi-structured open-ended questions and non-leading prompts, I engaged the study participants in free discussions in which they described their health-seeking behaviors, and factors they believed influenced and motivated them to engage or not to engage in specific health-seeking activities, for the treatment of breast ill-health. A demographic form, which was personally completed by each participant, was used to obtain the participants’ demographic information. The demographic information of the study participants were analyzed using descriptive statistics while the interview transcripts were analyzed using thematic analysis. Results: The main outcome of this dissertation research suggests that women in Southwestern Nigeria suffering from breast cancer have unique perceptions of breast cancer as a life-threatening illness that few people survive, may misinterpret breast changes perhaps due to poor knowledge of breast cancer symptoms, and seek divine intervention to manage the advanced stages of breast cancer. This study uncovered the women’s personal and cultural beliefs and attitudes about breast cancer. It also generated information that provided deeper understanding of their health-seeking behaviors, as well as pertinent factors that influence Southwestern Nigerian women suffering from breast cancer in their health seeking for the management of the illness. Conclusion: The outcomes of this study provided insight into how nurses can optimally and comprehensively manage breast cancer perceived to be a life-threatening illness that few people survive. This study also advanced the use of a qualitative approach to inquiry in seeking to explore and understand the health-seeking behaviors of women presenting with advanced breast cancer in Southwestern Nigeria, on which empirical literature had been scarce. It is hoped that this new understanding will contribute to the holistic nursing management of breast cancer that could result in improved treatment outcomes of the illness among women in Southwestern Nigeria

Effects of a psychosocial intervention on the quality of life or primary caregivers of women with breast cancer in Abuja, Nigeria

Studies have shown that limited attention has been paid to the psychosocial wellbeing of caregivers of patients undergoing care and treatment for breast cancer in Nigeria. There are no interventions in place to cater for their needs despite, the psychological problems faced by this group of people. This study investigated the effectiveness of a psychosocial intervention in term of impact on the quality of life (QOL) of primary caregivers of women with breast cancer in Abuja, Nigeria. Using a quasiexperimental design, sample of 108 participants assigned to the intervention and control groups, the study made use of the Zarit Burden Interview (ZBI) and Caregiver Quality of Life Index-Cancer (CQOLC) to measure caregiver burden and QOL respectively. The hypothesis for the study was that the primary caregivers of women with breast cancer who receive a psychosocial intervention programme will report improved QOL compared with caregivers who do not attend a psychosocial intervention programme. The study established that there were a negative linear relationship between caregiver burden and QOL (R = -0.45, p < 0.001) as a basis for intervention, and also that 29% variance of QOL could be explained by caregiver burden. The intervention results showed that at baseline 51.9% participants reported moderate to severe burden and 48.1% reported severe burden. These figures reduced to 22.3% and 12.6% for moderate to severe and severe burden respectively at 6 weeks after intervention, and further reduced to 18.6% and 4.9% respectively at 12 weeks after intervention. Comparing the QOL of the intervention and control groups, the results showed a significant difference on the score at baseline, 6 and 12 weeks. However, looking at performance of the intervention group, there was no significant different at baseline and 6 weeks (t=0.83, p < 0.05), and baseline and 12 weeks (t=1.65, p < 0.05). With reference to the caregiver burden of the intervention and control groups, it was found that a significant difference existed at baseline (t=9.33, p < 0.001). In respect of the impact of the intervention on caregiver burden of the intervention group, results showed a significant difference between baseline and 6 weeks (t=30.34, p < 0.001) and between baseline and 12 weeks (t = 36.80, p < 0.001) after intervention. The study concluded that the psycho-education intervention significantly affected caregiver burden but did not affect caregivers' QOL. Therefore, there is a need for a psycho-education intervention for caregivers of patients with breast cancer, in order to reduce the burden and help them cope with the work of caregiving. Appropriate supportive interventions should be made available to support the close family members of patients with breast cancer in order to reduce caregiver burden. Relevant stakeholders in the healthcare sector especially in palliative care should promote awareness of carer needs. The provision of intervention programmes for caregivers requires further research to develop contextually specific programmes and services which will improve the QOL of caregivers