Recognizing and appraising symptoms of breast cancer as a reason for delayed presentation in Ghanaian women: A qualitative study.

BackgroundThe burden of late presentation is well established in women presenting with advanced breast cancer in Africa. This paper aims to explore the reasons for delayed presentation in Ghanaian women with breast cancer.MethodEleven (11) women diagnosed with advanced breast cancer were purposively sampled within three years of diagnosis at the palliative care clinic of the Komfo Anokye Teaching Hospital, Ghana. Participation was voluntary. Data was collected through in-depth interviews using a self-devised semi-structured interview guide. The interviews were conducted in "Twi" (local language), audio-tape recorded and covered the women's journey from symptom discovery to their intention to seek help. All audio-taped interviews were transcribed based on the meaning of the respondents' comments. The data was managed using Nvivo version 11 qualitative software. Data was analyzed concurrently with data collection applying the principles of thematic analysis.Key findingsAll the women delayed presentation due to overlapping reasons. Symptom appraisal among the women occurred in two main stages: individual understanding of breast symptom and interactive understanding of the breast symptom. These stages were based on cognitive, psycho-cultural and social factors. The five main themes generated from the data were: symptom experience, knowledge of breast cancer, role of social life and network, coping with a breast symptom and lastly intent to seeking health care. A conceptual model was developed to illustrate the relationships among the key factors and concepts emanated from this study.ConclusionRecognition and appraisal of breast cancer symptom in the eleven (11) Ghanaian women interviewed in this study was poor. For instance, a painless breast lump was considered not serious until a sensory symptom appears. This led women to experience appraisal and time point intervals. To minimize the incidence of late presentation of breast cancer cases in Ghana, adequate educational intervention should be provided for Ghanaian women and their social network, and other stakeholders

Evidence of promoting prevention and the early detection of breast cancer among women, a hospital-based education and screening interventions in low- and middle-income countries: a systematic review protocol

Abstract Background Given the increasing burden of breast cancer in the low- and middle-income countries, cost-effective approaches are needed to improve the early detection of breast cancer in these continents. Global policies and guidelines are now placing much emphasis on promoting early detection of breast cancer through integrated education and screening interventions. The proposed systematic review aims to map evidence on hospital-based breast cancer education, breast self-examination, and clinical breast examination services for women in low- and middle-income countries. Methods/design We will conduct a systematic review of peer-reviewed studies on hospital-based breast cancer prevention intervention (breast cancer education, breast self-examination, and clinical breast examination) for women in low- and middle-income countries. An electronic search will be conducted in the following electronic databases CINAHL Plus with full text (EBSCOhost), MEDLINE with full-text (EBSCOhost) PsychINFO (EBSCOhost), and PubMed. Articles will also be searched through the “Cited by” search and citations included in the reference list of included articles. A two-stage mapping approach will be conducted. The first stage will involve screening studies through assessing their titles. Also, we will screen abstracts of identified studies descriptively and by focus and methods as dictated by the inclusion and exclusion criteria. The second stage will include extraction of data from eligible studies. A parallel screening and data extraction will be conducted by two reviewers. The quality of included studies will be assessed using the mixed methods appraisal tool (MMAT). A narrative account of the data extracted from the included studies will be analyzed using the thematic analysis. Discussion We hope to find relevant studies reporting evidence on promoting prevention and the early detection of breast cancer among women in a hospital-based education and screening interventions in low- and middle-income countries. The evidence obtained from the included studies when summarized will help guide future research. The study results will be disseminated electronically and in print. Also, it will be presented at conferences related to breast cancer. Systematic review registration The protocol has been registered with PROSPERO, with registration number CRD42017077818

Integration of breast cancer prevention and early detection into cancer palliative care model.

BackgroundBreast cancer is common among Ghanaian women. Late stage presentation has been credited to knowledge deficit and lack of breast cancer prevention and early detection services for women.ObjectiveThis study aimed to develop a model to facilitate the integration of breast cancer prevention and early detection into cancer palliative care.MethodThis study used synthesized concepts emerging from a single case study research. The case was a tertiary health care facility, embedded with sub-units of analysis. Mixed-method approach was used to collect data from 102 participants. The study examined the experiences and views of the participants on breast cancer and screening pathways in Ghana. Thematic analysis and descriptive statistics ware used to analyze the qualitative and quantitative data respectively. This was followed with a cross-case analysis across the sub-units of analysis. A theory development approach was further used towards the development of a model, following three steps: concept analysis, statement synthesis and theory synthesis.ResultsSix key concepts synthesized from the data were used to develop the model: initiate and sustain breast cancer prevention and early detection program, collaboration of health professionals, patients, families and micro-communities, conducive environment of the health care facility and needed resources, actions, services, and lastly diffusing innovation into the community through agents.ConclusionA model has been developed based on the experiences shared by women diagnosed with advanced breast cancer, their first degree relatives, micro-communities as well as clinicians working in a palliative care setting. This model will aid clinicians to provide breast cancer education, teach breast self-examination and offer clinical breast examination to families and micro-communities of advanced breast cancer patients receiving supportive care in a resource-limited setting

Cancer awareness among community pharmacist: a systematic review

Abstract Background The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. Methods EMBASE (ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. Results A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. Conclusion The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion

Evidence of Promoting Prevention and the Early Detection of Breast Cancer among Women, a Hospital based model in LMICs Data extraction forms (Responses).xlsx

<p>This is a systematic review. Ethical approval is not applicable. The study protocol was first developed and was registered in the PROSPERO international prospective register of systematic reviews (Chien, Khan, & Siassakos, 2012) (CRD42017077818). Employing standard systematic review strategies (Higgins & Green, 2011; Shamseer et al., 2015), we searched for all study types that focused on hospital/clinic based BC awareness and early detection services for healthy women in LMICs. The criteria for selecting the studies for review as well as the awareness and screening of interest (BCE, BSE and CBE) are shown in table 1.</p><p>Table 1: A PICOS framework for determining the eligibility of the Studies for the Primary Research Question</p><p>CriteriaDeterminants</p><p>P- PopulationThe population of this study will be healthy women with no evidence of malignancy accessing a BCE or screening intervention </p><p>I- InterventionPatient-focused BCE and raising awareness over risk factors, early BC signs and symptoms, BC screening and/or detection among women</p><p>C- ComparisonNone</p><p><br></p><p>O- Outcomes• Increased knowledge on BC</p><p>•Practice BSE</p><p>•Access CBE services</p><p>•Early detection of BC</p><p>•Reduced incidence of BC </p><p>S- Study SettingLMICs; within a health care facility (hospital/clinic) </p><div><br></div><div>The quality of included stuides were assessed using Effective Public Health Practice Project (EPHPP) Quality Assessment Tool recommended by Cochrane for quantitative studies (Effective Public Health Practice Project, 2010)<br></div><div>PRISMA diagram was used to summerized the selection procedure of the studies</div

How do caregivers of children living with HIV/AIDS cope, and where do they get support?: A qualitative study in Ghana

Abstract Background Caring for children living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is challenging and has a tremendous impact on the physical and psychological health of caregivers. Caregivers of children with HIV/AIDS need to adopt coping mechanisms to navigate these complexities as it influences the quality of care provided. The literature on coping strategies and support (formal and informal) available to caregivers of children living with HIV/AIDS is scant. This study aimed to explore the coping strategies and support systems for caregivers of children living with HIV/AIDS. Methods A phenomenological study design was adopted. A total of nine participants across three hospitals in the Tamale metropolis were interviewed using purposive sampling. The interviews were audio recorded, transcribed verbatim and analysed using Colaizzi's approach. Results Four main themes emerged from the analyses: (1) coping strategies, (2) types of support activities, (3) support from informal institutions and (4) support from formal institutions. The caregivers navigated the caring process with much spiritual coping. The caregivers had little or no support from informal institutions such as immediate family, faith and community leaders. Non‐governmental organizations were not visible in support, and there were no support groups for caregivers. Conclusion Support for caregivers and the active involvement of the immediate family in paediatric HIV care is imperative

Having a child with orofacial cleft: Initial reaction and psychosocial experiences of Ghanaian mothers

Background: Orofacial cleft are the most prevalent congenital deformity of the orofacial region. The birth of a child with orofacial cleft elicit emotional trauma in mothers. Objectives: The study explored the reactions and psychosocial experiences of Ghanaian mothers’ having children with cleft lip or/and palate in the Kumasi metropolis. Methods: The study employed a qualitative exploratory descriptive design to realize its objectives. Purposive sampling method was used and data saturation was achieved with 12 informants aged 18 years to above 40 years. All interviews were audio-taped and transcribed. Data analysis was done concurrently applying the techniques of thematic analysis. Results: Mothers’ described their initial reaction to the birth of the child as unexpected event with culminated experiences such as shock and disappointment, leading to rejection of the child. Mothers’ experienced emotional reactions such as sadness, anxiety and worry. Also, feeding challenges were experienced. Perceived and actual stigma were expressed which led to social isolation. They received support from their spouses and health professionals. Six main themes emerged were unexpected event, nutritional challenges, emotional reactions, participation restriction, losses and support. Conclusion: Mothers need supportive care from husbands, families and healthcare providers. There is also the need to educate the general public on orofacial cleft. Keywords: Qualitative research, Ghana, Experiences, Mother, Orofacial cleft, Chil