The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography
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.
Decision-making, Ethnography, Language barriers, Participant observation, Patient-provider relationships, Qualitative interviews, Socio-cultural factors
Agyemang, Linda Serwaa
b04bbc02-aab1-4902-b6c9-3f8b724e16e1
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Mclean, Chris
04c1b951-0f57-4d2e-a910-ea814c785166
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
15 October 2021
Agyemang, Linda Serwaa
b04bbc02-aab1-4902-b6c9-3f8b724e16e1
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Mclean, Chris
04c1b951-0f57-4d2e-a910-ea814c785166
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
Agyemang, Linda Serwaa, Foster, Claire, Mclean, Chris, Fenlon, Deborah and Wagland, Richard
(2021)
The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana: an ethnography.
BMC Women’s Health, 21 (1), [364].
(doi:10.1186/s12905-021-01502-2).
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.
Text
The cultural and structural influences that ‘hide’ information from women diagnosed with breast cancer in Ghana an ethnography
- Accepted Manuscript
More information
Accepted/In Press date: 15 September 2021
Published date: 15 October 2021
Additional Information:
Funding Information:
The study was funded by the Schlumberger Foundation.
Funding Information:
The authors acknowledge colleagues, Winfred Dotse-Gborgbortsi and Dr Beatrice Sankah, at the University of Southampton for reviewing the manuscript and give thanks to the respondents for participating in the study.
Publisher Copyright:
© 2021, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Decision-making, Ethnography, Language barriers, Participant observation, Patient-provider relationships, Qualitative interviews, Socio-cultural factors
Identifiers
Local EPrints ID: 452065
URI: http://eprints.soton.ac.uk/id/eprint/452065
ISSN: 1472-6874
PURE UUID: b494d2de-635c-49ba-bd76-041156b1b217
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Date deposited: 10 Nov 2021 17:33
Last modified: 17 Mar 2024 03:20
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Contributors
Author:
Linda Serwaa Agyemang
Author:
Deborah Fenlon
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