KNOWLEDGE, PERCEPTION AND HEALTH-SEEKING BEHAVIOUR OF WOMEN WITH BREAST CANCER AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Breast Cancer (BC) in women is a non-communicable disease of public health importance. In Nigeria, effective management of the disease mainly takes place in tertiary health care facilities and anecdote evidence shows that late presentation by cancer patients is responsible for low survival rate in developing countries. Breast cancer patients' knowledge and factors underlying their health-seeking behaviour which are needed for designing clinic-based educational services and BC-focused mass communication efforts is still under-investigated in Nigeria. This study therefore assessed the knowledge, perception and health seeking behaviour of women with BC who were attending the Oncology and Radiotherapy Clinics at the University College Hospital Ibadan, Nigeria, A cross-sectional study design was adopted and all the 300 consenting patients with confirmed BC were involved in the study from June, 2013 to February, 2014. A semi-structured questionnaire which included questions on socio-demographic characteristics, 32- point BC knowledge and 14-point BC perception scales as well as question on health-seeking behaviour was used for data collection. Knowledge scores <16. ≥ 16-19. >19-26. >26 were categorized as poor, fair, good and excellent respectively. Perception score <7 >7-9, >9 were classified as unfavorable, fairly favourable and very favourable respectively. Data were analysed using descriptive statistics, Chi-square test and ANOVA at p=0.05. Respondent' age was 50.0±11.0 years, 64.7% were married and 35.4% had tertiary education. Fifty-two percent heard about BC before the onset of the disease and major sources of information were radio (23.1%) and television (21.8%), Majority of respondents (69:7%) were not aware of breast self-examination and mammography (89.0%) for early dictation of symptoms of BC. Respondents' knowledge score was 17.6+.4.6 with those having poor, fairs good and excellent knowledge scores being 30.7%, 35.7%, 31.3% and 2.3% respectively. Spiritual attack (64.0%), keeping money in brassieres (2.8%) and "black blood" (30.0%) were reported as causes of BC. Respondents' perception score was 8.6±2.8, those with very favourable perception relating to BC were 46.3% while respondents with fairly favourable and unfavorable perception constituted 29.0% and 26.7% respectively. Majority (91.3%) perceived BC to be very serious. respondents who sought for orthodox and a combination of non-orthodox and orthodox treatment were 15.0% and 85.0% respectively. Majority (71.0%) commented treatment immediately after BC diagnosis. 21.0% delayed for some weeks while 7.7% delayed for some months. The most common reason for delay in seeking, treatment was financial difficulty (49.5%). Fifty-seven percent sought treatment when the symptoms became worse. Respondents with no formal education significantly had lower knowledge score (15.0±3.8) compared to those with primary education (15.9±4.0). Secondary education (17.0±5.0) and tertiary education (20.0±3.8). A significantly higher proportion of respondents aged <45 years (60.0%) had very favorably perception compared to those. aged >45 years (37.1%). Inadequate knowledge, unfavorable perception and inappropriate health-seeking behaviours were observed among breast cancer patients at University College Hospital. Patients education. Public enlightenment and social-marketing of breast self-examination and mammography screening are recommended to address the identified concerns.