scholarly journals Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study

2020 ◽  
Author(s):  
Jane Harries ◽  
Deborah Constant ◽  
Lydia Cairncross ◽  
Jennifer Moodley
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Cape Town ◽  
Fertility Intentions ◽  
Limited Information ◽  
Care Providers ◽  
Future Fertility ◽  
The Impact

Abstract Background: No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa. Methods: Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.

scholarly journals Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study

2020 ◽  
Author(s):  
Jane Harries ◽  
Deborah Constant ◽  
Lydia Cairncross ◽  
Jennifer Moodley
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Cape Town ◽  
Fertility Intentions ◽  
Limited Information ◽  
Care Providers ◽  
Future Fertility ◽  
The Impact

Abstract Background:No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.Methods:Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient- provider communication and counseling could address knowledge gaps

scholarly journals Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jane Harries ◽  
Deborah Constant ◽  
Lydia Cairncross ◽  
Jennifer Moodley
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Cape Town ◽  
Fertility Intentions ◽  
Limited Information ◽  
Care Providers ◽  
Future Fertility ◽  
The Impact

Abstract Background No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18–49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa. Methods Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.

scholarly journals Contraceptive Needs and Fertility Intentions of Women With Breast Cancer in Cape Town, South Africa: A Qualitative Study

2020 ◽  
Author(s):  
Jane Harries ◽  
Deborah Constant ◽  
Lydia Cairncross ◽  
Jennifer Moodley
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Cape Town ◽  
Fertility Intentions ◽  
Limited Information ◽  
Care Providers ◽  
Future Fertility ◽  
The Impact

Abstract Background: No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18–49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa. Methods: Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions: Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient- provider communication and counseling could address knowledge gaps.

scholarly journals Impact of Breast Cancer Early Detection Training on Rwandan Health Workers’ Knowledge and Skills

2018 ◽  
pp. 1-10 ◽  
Author(s):  
Lydia E. Pace ◽  
Jean-Marie Vianney Dusengimana ◽  
Nancy L. Keating ◽  
Vedaste Hategekimana ◽  
Vestine Rugema ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Center ◽  
Health Care Providers ◽  
Health Workers ◽  
Critical Role ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Knowledge And Skills ◽  
Written Test ◽  
The Impact

Purpose In April 2015, we initiated a training program to facilitate earlier diagnosis of breast cancer among women with breast symptoms in rural Rwanda. The goal of this study was to assess the impact of the training intervention in breast cancer detection on knowledge and skills among health center nurses and community health workers (CHWs). Methods We assessed nurses’ and CHWs’ knowledge about breast cancer risk factors, signs and symptoms, and treatability through a written test administered immediately before, immediately after, and 3 months after trainings. We assessed nurses’ skills in clinical breast examination immediately before and after trainings and then during ongoing mentorship by a nurse midwife. We also examined the appropriateness of referrals made to the hospital by health center nurses. Results Nurses’ and CHWs’ written test scores improved substantially after the trainings (overall percentage correct increased from 73.9% to 91.3% among nurses and from 75.0% to 93.8% among CHWs ( P < .001 for both), and this improvement was sustained 3 months after the trainings. On checklists that assessed skills, nurses’ median percentage of actions performed correctly was 24% before the training. Nurses’ skills improved significantly after the training and were maintained during the mentorship period (the median score was 88% after training and during mentorship; P < .001). In total, 96.1% of patients seen for breast concerns at the project’s hospital-based clinic were deemed to have been appropriately referred. Conclusion Nurses and CHWs demonstrated substantially improved knowledge about breast cancer and skills in evaluating and managing breast concerns after brief trainings. With adequate training, mentorship, and established care delivery and referral systems, primary health care providers in sub-Saharan Africa can play a critical role in earlier detection of breast cancer.

scholarly journals Clinical profile and management of breast cancer in women in a rural based tertiary care hospital our experience

2017 ◽  
Vol 4 (2) ◽  
pp. 697
Author(s):  
Ambikavathy Mohan ◽  
Chandan Kumar
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Carcinoma ◽  
Health Care Providers ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Care Providers ◽  
Increased Risk ◽  
The Impact ◽  
Women In India

Background: Breast cancer is the second most common cancer among women in India and accounts for 7% of global burden of breast cancer and one-fifth of all cancers among women in India. The risk factors are related to lifestyle, early menarche, nulli parity, prolonged use of oral contraceptive pills, hormone replacement therapy, not breast‑feeding, alcohol, obesity, lack of exercise, and induced abortion. A woman who attains menopause after fifty five years of age has an increased risk of ovarian, breast, and uterine cancers. The risk is greater if a woman also began menstruating before twelve years of age. A longer exposure to estrogen increases a woman’s risk of breast cancers.Methods: This is a prospective observational study, conducted in the department of surgery, between December 2013 and June 2015(2 years). Patients diagnosed as breast carcinoma and admitted in surgical wards were included, Data pertaining to demography, clinical and pathological tumor profile, and treatment details were collected prospectively for each patient based on patient interviews and medical records. To analyse the Prevalence of breast cancer, clinical presentation, risk factors, diagnostic methods, treatment protocols, difference between pre and post‑menopausal breast cancer women regarding risk factors, assess the impact of treatment given and women’s knowledge about breast cancer.Results: A total number of 25 cases of breast carcinoma based on detailed history, clinical examination, Trucut biopsy, ultrasonography breast and axilla, ultrasound abdomen, mammogram and chest x-ray were analysed. All of them received three cycles of anterior chemotherapy consisting of 5- Fluorouracil 500 mg/m2,Adriamycin 50 mg/m2 Cyclophosphamide 80 mg/m2 (FAC regimen) administered intravenously followed by modified radical mastectomy. There were no recurrences seen on follow up till date.Conclusions: Late stage at presentation of breast cancer is a challenge to the health care providers. Cancer awareness programmes, multidisciplinary approach and evidence‑based strategies for early detection and effective management of the disease can go a long way in prevention.

scholarly journals Breast Cancer Patients’ Experience and Wishes Regarding Communication on Sexual Health - The BEROSE Study

2021 ◽  
Author(s):  
Marion Aupomerol ◽  
Dan Chaltiel ◽  
Patricia Pautier ◽  
Delphine Wehrer ◽  
Lucie Veron ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Health ◽  
Health Care Providers ◽  
Cancer Center ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Lack Of Information ◽  
Treatment Administration ◽  
The Impact

Abstract Purpose: Although sexual health (SH) is a major concern for many patients with breast cancer (BC), only few of them receive adequate information on this topic throughout their care. BEROSE is a single-center pilot cross-sectional observational study, which aimed at evaluating communication on SH between women with BC and their health-care providers.Methods: From June 12th to July 31th, 2020, a survey was distributed to patients consulting at Breast Cancer Unit of Gustave Roussy Cancer Center. The primary endpoint was the rate of women reporting to have received information on SH from health professionals throughout active treatment administration or BC follow-up.Results: Of 348 surveys collected, 318 were completely filled and included in the analysis. Sixty-one percent of women were older than 50 years and 65% had a localized BC. The majority (63%) was receiving hormone-therapy (37%) or chemotherapy (26%). Overall, 65% reported that they had not received any information about SH throughout their care, while 69% felt it would have been important to discuss sexual issues. Most of women expected professionals to bring up the topic, preferably oncologists or gynecologists, during face-to-face consultations. Concerning satisfaction on SH, 83% reported of being satisfied or very satisfied before BC diagnosis, and only 30% at the time of our survey. Conclusion: Most of women treated or followed-up for BC feel that they lack of information regarding SH-related issues. The impact of BC diagnosis and treatment on SH should be discussed with all women from the first visit and then regularly readdressed.

scholarly journals Breast Cancer Patients’ Experience and Wishes Regarding Communication on Sexual Health - The BEROSE Study

2021 ◽  
Author(s):  
Marion Aupomerol ◽  
Dan Chaltiel ◽  
Patricia Pautier ◽  
Delphine Wehrer ◽  
Lucie Véron ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Health ◽  
Health Care Providers ◽  
Care Pathway ◽  
Cancer Center ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
Adequate Information ◽  
The Impact

Abstract Purpose: Although sexual health (SH) is a major concern for many patients with breast cancer (BC), only few of them receive adequate information on this topic throughout their whole care pathway. BEROSE is a single-center pilot cross-sectional observational study, which aimed at evaluating communication on SH between women with BC and their health-care providers.Methods: From June 12th to July 31st, 2020, a survey was distributed to patients consulting at Breast Cancer Unit of Gustave Roussy Cancer Center. The primary endpoint was the rate of women reporting to have received information on SH from health professionals throughout active treatment administration or BC follow-up.Results: Of 348 surveys collected, 318 were fully completed and included in the analysis. Sixty-one percent of women were older than 50 years and 65% had a localized BC. The majority (63%) was receiving hormone-therapy (37%) or chemotherapy (26%). Overall, 65% reported that they had not received any information about SH throughout their care, while 69% felt it would have been important to discuss sexual issues. For 31% of women, professionals, preferably oncologists or gynecologists, should have initiated the discussion on SH, during an in-person consultation. Concerning satisfaction on SH, 83% reported being satisfied or very satisfied before BC diagnosis, and only 30% at the time they completed the survey.Conclusion: Most of women undergoing treatment or follow-up for BC feel that they lack of adequate information regarding sexual issues associated to BC. The impact of BC diagnosis and treatment on SH should be discussed with all women from the first visit and then regularly readdressed.

scholarly journals Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yolandie Kriel ◽  
Cecilia Milford ◽  
Joanna Paula Cordero ◽  
Fatima Suleman ◽  
Petrus S. Steyn ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Quality Of Care ◽  
Family Planning ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Care Providers ◽  
Contraceptive Methods ◽  
Integration Of Services

Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public health care service, little is known about family planning specific quality of care in South Africa. This paper aims to fill the gap in the research by using the Bruce-Jain family planning quality of care framework. Methods This formative qualitative study was conducted in South Africa, Zambia, and Kenya to explore the uptake of family planning and contraception. The results presented in this paper are from the South African data. Fourteen focus group discussions, twelve with community members and two with health care providers, were conducted along with eight in-depth interviews with key informants. Thematic content analysis using the Bruce-Jain Quality of Care framework was conducted to analyse this data using NVIVO 10. Results Family planning quality of care was defined by participants as the quality of contraceptive methods, attitudes of health care providers, and outcomes of contraceptive use. The data showed that women have limited autonomy in their choice to either use contraception or the method that they might prefer. Important elements that relate to quality of care were identified and described by participants and grouped according to the structural or process components of the framework. Structure-related sub-themes identified included the lack of technically trained providers; integration of services that contributed to long waiting times and mixing of a variety of clients; and poor infrastructure. Sub-themes raised under the process category included poor interpersonal relations; lack of counselling/information exchange, fear; and time constraints. Neither providers nor users discussed follow up mechanisms which is a key aspect to ensure continuity of contraceptive use. Conclusion Using a qualitative methodology and applying the Bruce-Jain Quality of Care framework provided key insights into perceptions and challenges about family planning quality of care. Identifying which components are specific to family planning is important for improving contraceptive outcomes. In particular, autonomy in user choice of contraceptive method, integration of services, and the acceptability of overall family planning care was raised as areas of concern.

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