Abstract
Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detection can lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public health midwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions on improving existing breast cancer early detection services provided through Well Woman Clinics. A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in the Gampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. All the PHMs had a firm realization on the need of breast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacy of training, lack of skills and material to provide health education, inability to provide privacy during clinical examination, shortage of stationery, lack of community awareness and motivation. The suggestions for the improvements of the programme identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. Results of the FGDs can provide useful information on components to be improved in breast cancer early detection services. Study recommendations were training programmes at basic and post basic levels on a regular basis and supervision for the sustainance of the breast cancer early detection program.
Highlights
Breast cancer is the most common cancer and is the leading cause of cancer death among women worldwide (Parkin et al, 2005; Benson and Jatoi, 2012; Bray et al, 2013)
The suggestions for the improvements of the programme identified in focus group discussions (FGDs) were capacity building of public health midwives (PHMs), making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness
Breast self-examination (BSE), clinical breast examination (CBE) and mammography are the methods used for early detection of breast cancer
Summary
Breast cancer is the most common cancer and is the leading cause of cancer death among women worldwide (Parkin et al, 2005; Benson and Jatoi, 2012; Bray et al, 2013). Women over 35 years of age get them screened for hypertension, diabetes mellitus, breast malignancies and cervical cancer in WWCs. CBE and increasing awareness on BSE are conducted for breast cancer early detection. Present study was conducted with the aim to identify PHMs’ perceptions on the importance and deficiencies of the existing breast cancer early detection services provided through WWCs and to identify their suggestions on improving the breast cancer early detection services. Qualitative methodology seemed to be ideal for assessment of the views of the PHM on breast cancer early detection programme: focus group discussions (FGDs) which are frequently used to obtain perspectives and attitudes of people about issues, seek explanations for behaviour, triangulation of data obtained through quantitative methods and generation of hypotheses (Lakshman et al, 2000) were used in the present study
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