Browsing by Author "Kepkey, Brigitta Blumé"

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    Barriers to and facilitators of adherence to intravenous chemotherapy among breast cancer patients at a tertiary hospital in the Western Cape
    (Stellenbosch : Stellenbosch University, 2022-04) Kepkey, Brigitta Blumé; Coetzee, Bronwyne; Kagee, Ashraf; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH SUMMARY: Worldwide, breast cancer is the most commonly diagnosed cancer as well as the leading cause of cancer-related death among women. The estimated incidence of breast cancer is expected to rise, with the majority of breast cancer cases occurring among women in low and middle-income countries (LMIC) such as South Africa, where adherence to treatment for cancer remains a challenge. Adherence to treatment for cancer is essential in order for breast cancer patients to achieve optimal health and treatment outcomes. In South Africa, factors that affect adherence to intravenous chemotherapy, one of three treatment options available to breast cancer patients, have not been well-documented within the literature. The qualitative research study reported on here is an effort to explore the factors that influence adherence to intravenous chemotherapy among breast cancer patients at a tertiary hospital in the Western Cape, South Africa. The perspectives of breast cancer patients, family members and healthcare workers, including doctors and nurses from the breast clinic and chemotherapy unit at the tertiary hospital, have been elicited. Participants in the present study included nine breast cancer patients, three family members and eight healthcare workers. Using semi-structured interviews, data describing participants’ perspectives of the adherence-related factors of patients were collected. Through the lens of the Ecological Systems Theory (EST), nine main themes and 21 sub-themes were identified and interpreted using thematic analysis and a qualitative software programme. The most salient barriers to adherence identified at the microsystem level were treatment side effects and transport and finances. The most salient facilitators of adherence to treatment were patients’ self-motivation to complete treatment as well as symptom improvement as a result of chemotherapy. The most salient barriers identified at the mesosystem level was lack of social support and the most salient facilitators of adherence were shown to be social support received from relatives and friends as well as healthcare workers. At the exosystemic level, the most salient barrier to adherence was lack of oncology-trained staff and the most salient facilitators of adherence were the fee subsidy and hospital transport. The research study’s findings demonstrated that breast cancer patients’ adherence to treatment was shaped and influenced by their interactions with family, friends, healthcare workers as well as poverty-related and institution-related factors. Patients’ understanding, knowledge and access to information regarding breast cancer and its treatment mechanisms also served as important determinants of adherence.