Determinants of initiating cancer treatment among breast cancer survivors: a descriptive qualitative study

Abstract

Background:

The timing of cancer treatment initiation is a critical factor impacting cancer metastasis, recurrence, morbidity, mortality and overall survival rates. Based on the Health Belief Model, health beliefs and cues to action may influence treatment initiation in women with breast cancer.

Aim:

This study aimed to explore health beliefs and cues to initiate treatment among breast cancer survivors.

Methods:

Breast cancer survivors undergoing cancer treatment were recruited for a descriptive qualitative study. Semi-structured interviews were conducted. A content analysis was undertaken.

Results:

Breast cancer survivors (N = 25) had a mean age of 51.6 years, were primarily Caucasian (n = 17; 68%), and on average 31 months post-diagnosis. Health belief subcategories emerged: (1) personal, social and cancer-related benefits; (2) personal, social, physical/health, financial/health insurance-related, treatment-related, facility-related and community-related barriers; (3) perceived threats involving death, cancer spreading, recurrence and more aggressive treatments and (4) self-efficacy influenced by a support system, trusted healthcare professionals, and life responsibilities. The cues to initiate treatment were social, mental, individual, and healthcare-related.

Conclusion:

Women’s health beliefs and cues to initiate treatment could be assessed by nurses and other disciplines working collaboratively to minimise the challenges that may cause delayed treatment initiation. Advocating for policies is recommended.