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The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography

Linda Serwaa Agyemang, Claire Foster, Chris McLean, Deborah Fenlon, Richard Wagland

BMC Women's Health, Volume: 21, Issue: 1, Start page: 364

Swansea University Author: Deborah Fenlon

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DOI (Published version): 10.1186/s12905-021-01502-2

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Abstract: Background: Socio-cultural factors may influence the uptake of breast cancer treatments. This study aimed to explore these socio-cultural influences on treatment decision-making for women in Ghana. Method: An ethnographic approach was adopted. Observation was conducted of women newly diagn...

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Published in: BMC Women's Health
ISSN: 1472-6874
Published: Springer Science and Business Media LLC 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa58391
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first_indexed 2021-10-18T14:36:05Z
last_indexed 2021-11-04T04:24:42Z
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spelling 2021-11-03T12:32:31.3336322 v2 58391 2021-10-18 The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography efa6c181fe0a6e5c923b1126ce469186 Deborah Fenlon Deborah Fenlon true false 2021-10-18 FGMHL Abstract: Background: Socio-cultural factors may influence the uptake of breast cancer treatments. This study aimed to explore these socio-cultural influences on treatment decision-making for women in Ghana. Method: An ethnographic approach was adopted. Observation was conducted of women newly diagnosed with breast cancer, nominated relatives, nurses and doctors at a breast clinic in Ghana. Semi-structured interviews followed participant observation. Thematic analysis was employed. Findings: Over 16 weeks (July 2017–November 2017), 31 participants were observed and 29 took part in semi-structured interviews. Three overarching themes were identified: (1) unequal power relationships; (2) Language barriers and (3) structural constraints. Following a breast cancer diagnosis, essential information necessary for treatment decision making is ‘hidden’ from women due to an unequal patient-provider relationship. Patients acknowledged cultural behaviours of deference to experts. Doctors deliberately misrepresented treatment information to women to encourage them to undergo surgical treatment. Structural issues such as the lack of privacy during consultations hindered quality patient engagement with decision-making. High treatment costs and the lack of resources to assist women with fertility after treatment impeded open discussions around these issues. Language barriers included a lack of terms in the local Twi language to explain cancer and its treatment. There was also an absence of appropriate information materials. Conclusion: Findings highlight the need for health professionals to be aware of the socio-cultural factors that limit access to quality information which is needed for informed treatment decision making. Policies that aim to provide adequate logistics; increase staffing levels; improve staff cultural awareness training and remove financial barriers are recommended. Journal Article BMC Women's Health 21 1 364 Springer Science and Business Media LLC 1472-6874 Research, Patient-provider relationships, Socio-cultural factors, Language barriers, Participant observation, Qualitative interviews, Ethnography, Decision-making 15 10 2021 2021-10-15 10.1186/s12905-021-01502-2 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University Schlumberger Foundation 2021-11-03T12:32:31.3336322 2021-10-18T15:32:42.8984325 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Linda Serwaa Agyemang 1 Claire Foster 2 Chris McLean 3 Deborah Fenlon 4 Richard Wagland 5 58391__21214__e08b0614ec9d45ec91ed7a0f2d7ba3f0.pdf s12905-021-01502-2.pdf 2021-10-18T15:35:15.0208229 Output 1074327 application/pdf Version of Record true © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
spellingShingle The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
Deborah Fenlon
title_short The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
title_full The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
title_fullStr The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
title_full_unstemmed The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
title_sort The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
author_id_str_mv efa6c181fe0a6e5c923b1126ce469186
author_id_fullname_str_mv efa6c181fe0a6e5c923b1126ce469186_***_Deborah Fenlon
author Deborah Fenlon
author2 Linda Serwaa Agyemang
Claire Foster
Chris McLean
Deborah Fenlon
Richard Wagland
format Journal article
container_title BMC Women's Health
container_volume 21
container_issue 1
container_start_page 364
publishDate 2021
institution Swansea University
issn 1472-6874
doi_str_mv 10.1186/s12905-021-01502-2
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
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description Abstract: Background: Socio-cultural factors may influence the uptake of breast cancer treatments. This study aimed to explore these socio-cultural influences on treatment decision-making for women in Ghana. Method: An ethnographic approach was adopted. Observation was conducted of women newly diagnosed with breast cancer, nominated relatives, nurses and doctors at a breast clinic in Ghana. Semi-structured interviews followed participant observation. Thematic analysis was employed. Findings: Over 16 weeks (July 2017–November 2017), 31 participants were observed and 29 took part in semi-structured interviews. Three overarching themes were identified: (1) unequal power relationships; (2) Language barriers and (3) structural constraints. Following a breast cancer diagnosis, essential information necessary for treatment decision making is ‘hidden’ from women due to an unequal patient-provider relationship. Patients acknowledged cultural behaviours of deference to experts. Doctors deliberately misrepresented treatment information to women to encourage them to undergo surgical treatment. Structural issues such as the lack of privacy during consultations hindered quality patient engagement with decision-making. High treatment costs and the lack of resources to assist women with fertility after treatment impeded open discussions around these issues. Language barriers included a lack of terms in the local Twi language to explain cancer and its treatment. There was also an absence of appropriate information materials. Conclusion: Findings highlight the need for health professionals to be aware of the socio-cultural factors that limit access to quality information which is needed for informed treatment decision making. Policies that aim to provide adequate logistics; increase staffing levels; improve staff cultural awareness training and remove financial barriers are recommended.
published_date 2021-10-15T04:14:53Z
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