To disclose or not to disclose: an ethnographic exploration of factors contributing to the (non) disclosure of Ghanaian women’s breast cancer diagnosis to social networks
To disclose or not to disclose: an ethnographic exploration of factors contributing to the (non) disclosure of Ghanaian women’s breast cancer diagnosis to social networks
Background: although there may be theoretical support linking positive health outcomes with cancer disclosure to social networks, women from contexts such as Ghana where cancer is not openly talked about may have concerns around breast cancer disclosure. Women may not be able to share their experiences about their diagnosis, which may prevent them from receiving support. This study aimed to obtain the views of Ghanaian women diagnosed with breast cancer about factors contributing to (non) disclosure.
Methods: this study is based on secondary findings from an ethnographic study that employed participant observation and semi-structured face to face interviews. The study was conducted at a breast clinic in a Teaching Hospital in southern Ghana. 16 women diagnosed with breast cancer (up to stage 3); five relatives nominated by these women and ten healthcare professionals (HCPs) participated in the study. Factors contributing to breast cancer (non) disclosure were explored. Data were analysed using a thematic approach.
Results: the analysis indicated that most of the women and family members were very reticent about breast cancer disclosure and were secretive with distant relatives and wider social networks. Whilst remaining silent about their cancer diagnosis helped women protect their identities, prevented spiritual attack, and bad advice, the need for emotional and financial support for cancer treatment triggered disclosure to close family, friends, and pastors. Some women were discouraged from persevering with conventional treatment following disclosure to their close relatives.
Conclusions: breast cancer stigma and fears around disclosure hindered women from disclosing to individuals in their social networks. Women disclosed to their close relatives for support, but this was not always safe. Health care professionals are well placed to explore women’s concerns and facilitate disclosure within safe spaces to enhance engagement with breast cancer care services.
Agyemang, Linda Serwaa
b04bbc02-aab1-4902-b6c9-3f8b724e16e1
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Mclean, Chris
04c1b951-0f57-4d2e-a910-ea814c785166
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
10 July 2023
Agyemang, Linda Serwaa
b04bbc02-aab1-4902-b6c9-3f8b724e16e1
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Mclean, Chris
04c1b951-0f57-4d2e-a910-ea814c785166
Fenlon, Deborah
52f9a9f1-1643-449c-9856-258ef563342c
Agyemang, Linda Serwaa, Wagland, Richard, Foster, Claire, Mclean, Chris and Fenlon, Deborah
(2023)
To disclose or not to disclose: an ethnographic exploration of factors contributing to the (non) disclosure of Ghanaian women’s breast cancer diagnosis to social networks.
BMC Women's Health, 23 (1), [366].
(doi:10.1186/s12905-023-02508-8).
Abstract
Background: although there may be theoretical support linking positive health outcomes with cancer disclosure to social networks, women from contexts such as Ghana where cancer is not openly talked about may have concerns around breast cancer disclosure. Women may not be able to share their experiences about their diagnosis, which may prevent them from receiving support. This study aimed to obtain the views of Ghanaian women diagnosed with breast cancer about factors contributing to (non) disclosure.
Methods: this study is based on secondary findings from an ethnographic study that employed participant observation and semi-structured face to face interviews. The study was conducted at a breast clinic in a Teaching Hospital in southern Ghana. 16 women diagnosed with breast cancer (up to stage 3); five relatives nominated by these women and ten healthcare professionals (HCPs) participated in the study. Factors contributing to breast cancer (non) disclosure were explored. Data were analysed using a thematic approach.
Results: the analysis indicated that most of the women and family members were very reticent about breast cancer disclosure and were secretive with distant relatives and wider social networks. Whilst remaining silent about their cancer diagnosis helped women protect their identities, prevented spiritual attack, and bad advice, the need for emotional and financial support for cancer treatment triggered disclosure to close family, friends, and pastors. Some women were discouraged from persevering with conventional treatment following disclosure to their close relatives.
Conclusions: breast cancer stigma and fears around disclosure hindered women from disclosing to individuals in their social networks. Women disclosed to their close relatives for support, but this was not always safe. Health care professionals are well placed to explore women’s concerns and facilitate disclosure within safe spaces to enhance engagement with breast cancer care services.
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364_To disclose or not to disclose an ethnographic exploration of factors contributing to the non disclosure of Ghanaian women’s breast cancer diagnosis to social networks
- Accepted Manuscript
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s12905-023-02508-8
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More information
Accepted/In Press date: 24 June 2023
Published date: 10 July 2023
Additional Information:
Funding Information:
The authors are grateful to the participants in this study, and to Dr Beatrice Sankah, University of Southampton and Dr Leslie Gelling, University of Bournemouth, for reviewing this manuscript. The authors would also like to acknowledge Schlumberger Foundation for funding the study.
Identifiers
Local EPrints ID: 479550
URI: http://eprints.soton.ac.uk/id/eprint/479550
PURE UUID: 43dc3429-5407-4737-87b5-a9f87cd6d8c7
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Date deposited: 26 Jul 2023 16:37
Last modified: 18 Mar 2024 03:15
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Author:
Linda Serwaa Agyemang
Author:
Deborah Fenlon
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