Health Seeking Behaviour among Cancer Patients with the aid of Geographic Information System: A Mixed-Methods Study from Western India

利用地理信息系统研究癌症患者的就医行为:一项来自印度西部地区的混合方法研究

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Abstract

BACKGROUND AND OBJECTIVE: Cancer prognosis depends on early diagnosis and treatment and awareness, beliefs, accessibility, and affordability of health services. Delays in patients seeking health care increase mortality risk. This study has been undertaken in rural Jodhpur (Rajasthan, Western India) to determine the health-seeking behaviour related to common cancers and the factors affecting them. METHODOLOGY: A community-based mixed-methods study was conducted in randomly chosen one-third of the Mandore block of Jodhpur villages. Data was collected from individuals diagnosed with cancer/their relatives. In-depth interviews (IDI) were conducted with the frontline workers, cancer survivors, and their caregivers. A geographic information system (GIS) was also used to depict healthcare facilities accessed by cancer patients. RESULTS: A total of 146 participants (diagnosed with cancer) were included in the study. About one-third (34.2%) preferred alternative medicine along with allopathic medicine. The behaviour of changing hospitals frequently was depicted mostly by patients suffering from primary brain tumours (62.5%). Forty-five (31%) participants did not continue their treatment after initiation. From the content analysis of IDI, major factors for delays in health-seeking were misconceptions, superstitions, stigmatisation, financial burden, miscommunication from doctors, no proper referral mechanism, and unfelt need to visit healthcare. None of the participants were aware of the screening services provided and the benefits of screening services. Availability of initial treatment at peripheral centres and training activities for frontline workers and teachers were the major recommendations to improve cancer prevention and control.  Conclusions: Alternative medicine usage was common among cancer patients. Leaving treatment in between was also observed among one-third of the participants. Misconceptions, superstitions, stigmatisation, and financial burden were major factors enlisted for health-seeking delays.

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