Barriers to and facilitators of adherence to intravenous chemotherapy among breast cancer patients at a tertiary hospital in the Western Cape

Simple item page
dc.contributor.advisorCoetzee, Bronwyneen_ZA
dc.contributor.advisorKagee, Ashrafen_ZA
dc.contributor.authorKepkey, Brigitta Bluméen_ZA
dc.contributor.otherStellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.en_ZA
dc.date.accessioned2022-02-22T13:05:14Zen_ZA
dc.date.accessioned2022-04-29T09:27:02Zen_ZA
dc.date.available2022-02-22T13:05:14Zen_ZA
dc.date.available2022-04-29T09:27:02Zen_ZA
dc.date.issued2022-04en_ZA
dc.descriptionThesis (MA)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANS OPSOMMING: Wêreldwyd is borskanker die mees algemene kanker wat by vroue gediagnoseer word en is ook die belangrikste oorsaak van kanker-verwante sterftes. Daar word verwag dat die voorkoms van borskanker sal verhoog, met die oorgrote meerderheid van borskanker gevalle in lae- en middel inkomste (LMIL) lande soos Suid-Afrika, waar volhouding met kankerbehandeling ‘n uitdaging bly. Om optimale gesondheids- en behandelingsuitkomstes vir borskankerpasiёnte te bereik is behandelingsvolhouding baie belangrik. In Suid-Afrika word die faktore wat die volhouding van binne-aarse chemoterapie (een van drie behandelingsopsies beskikbaar vir borskankerpasiёnte) beïnvloed nie goed in die literatuur gedokumenteer nie. Die kwalitatiewe navorsingstuk waaroor hier verslag gedoen word is ’n poging tot die ondersoek van die faktore wat die volhouding van binne-aarse chemoterapeutiese behandeling onder borskankerpasiёnte by ‘n opleidingshospitaal in die Wes-Kaap in Suid-Afrika beïnvloed. Die perspektiewe van borskankerpasiёnte, familielede en gesondheidswerkers (insluitende dokters en verpleegsters van die borskliniek en chemoterapie-eenheid by die opleidingshospitaal) is vasgestel. Nege borskankerpasiёnte, drie familielede en agt gesondheidswerkers het aan die navorsing deelgeneem. Semi-gestruktureerde onderhoude is gebruik om data oor die beskrywing van die deelnemers se perspektiewe aangaande volhoudingsverwante faktore te versamel. Deur die lens van die Ekologiese Stelselteorie (EST) is tematiese ontleding met die behulp van ‘n kwalitatiewe rekenaarprogrammatuur gebruik om nege hooftemas en 21 sub-temas uit te ken en ïnterpreteer. Die opvallendste hindernis vir volhouding van behandeling op die mikrosisteemvlak blyk behandelingsnewe-effekte, vervoer en finansies te wees. Die uitstaande fasiliteerders vir behandelingsvolhouding was die pasiënt se self-motivering om die behandeling te voltooi asook die verbetering van simptome as gevolg van die chemoterapie. Op die mesosisteemvlak is die mees opvallende hindernisse ten opsigte van behandelingsvolhouding ’n gebrek aan sosiale ondersteuning en die duidelikste fasiliteerders was sosiale ondersteuning van familie, vriende en gesondheidswerkers. Op die eksosisteemvlak is bevind dat die belangrikste rede vir volhoudingsversuim die gebrek aan onkologie-opgeleide personeel was en die bydraende fasiliteerders tot sodanige versuim, die tariefsubsidie en die vervoer na en van die hospitaal was. Die bevindings van hierdie navorsingstuk toon aan dat versuim tot volgehoue behandeling onder borskankerpasiёnte veroorsaak en beïnvloed word deur hulle interaksie met familie, vriende en gesondheidswerkers, sowel as deur armoede- en faktore verwant aan die behandelingsinrigting. Die pasiënte se insig in, kennis van en toegang tot inligting aangaande borskanker en die behandelingswyses daarvan, dien ook as belangrike bepalers van behandelingsvolhouding.af_ZA
dc.description.versionMastersen_ZA
dc.format.extentxviii, 188 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/124696en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectBreast -- Cancer -- Treatmenten_ZA
dc.subjectBreast -- Cancer -- Patientsen_ZA
dc.subjectChemotherapyen_ZA
dc.subjectCancer-related deathen_ZA
dc.subjectCancer in womenen_ZA
dc.subjectPatient complianceen_ZA
dc.titleBarriers to and facilitators of adherence to intravenous chemotherapy among breast cancer patients at a tertiary hospital in the Western Capeen_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
kepkey_barriers_2022.pdf
Size:
5.42 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters Degrees (Psychology)