Abstract
Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta- synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.
Highlights
Breast cancer is the leading cause of death among women
Women included in the identified studies represented three major ethnic groups in Malaysia; it is shown that 72% of study population was Malay and only 8% from Indian representative. 50% of study population fall under middle age group of 40 to 50 year old and 87% of the studies women are married
Barriers to health seeking among breast cancer women in Malaysia summarized from the nine studies included: i) Lack of knowledge about breast cancer and breast cancer symptoms, ii) Denial and Psychological defense iii) Fear of cancer consequences, iv) Fear of surgery and treatment side effects, v) Believe in alternative treatment, vi) Influences of other in symptoms appraisal and decision making, vii) Health system weakness and viii) Other priorities taking precedence over personal health
Summary
Breast cancer is the leading cause of death among women. In year 2012 more than 1.5 million new cases of breast cancer were reported globally and the incidence has increased by 20.0% (Cancer, 2014). Women from UK and US were observed to be at a higher risk, with age standardize rate of more than 120 in 100,000 populations (Cancer Research UK, 2002; Siegel et al, 2014). A five year survival rate is observed among the 80-90% of the UK and US patients (Cancer Research UK, 2002), which is up to 50-60% among the patients from India, Thailand and Malaysia (Abdullah et al, 2013). Breast cancer screening practices are significantly lower among women in China; 20.0% and Malaysia; 4.0% compare to UK; 70.0% (Lawrence et al, 2007)
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