Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.

Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiat...

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Autores principales:	Bethel Teshome, Josephin Trabitzsch, Tsion Afework, Adamu Addissie, Mirgissa Kaba, Eva Johanna Kantelhardt, Sefonias Getachew
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6f4e573169d148d8ac51df80a280b8fa
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spelling	oai:doaj.org-article:6f4e573169d148d8ac51df80a280b8fa2021-12-02T20:08:18ZPerceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.1932-620310.1371/journal.pone.0257163https://doaj.org/article/6f4e573169d148d8ac51df80a280b8fa2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257163https://doaj.org/toc/1932-6203Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiation intervals of breast cancer patients and quantified the impact of socio-demographic and clinical factors, perceived barriers, and the patients´ perceived social support status on timely systemic treatment initiation (chemotherapy or hormonal therapy). A structured questionnaire was designed based on Pechansky´s "Concept of Access". Applying simple and multivariate logistic regression we analysed the influence of patients´ characteristics as well as their perceived barriers on timely treatment initiation. We measured social support with the Multidimensional Score of Perceived Social Support (MSPSS) and used the Wilcoxon Rank-Sum Test to assess its relationship with timely treatment initiation. Of 196 patients included into the study, 53% received systemic treatment within 90 days of their pathological diagnosis-the median treatment initiation interval was 85 days (IQR 123.5). Older women and patients diagnosed at late stages had higher odds of timely treatment initiation. Not being able to pay for services and lack of transport were most often perceived as barriers towards timely care. However, none of the perceived barriers showed a substantial influence on timely treatment initiation in the multivariate regression model. The patients´ perceived social support was found to be high, with an average MSPSS score of 73 out of 84 (SD 13,63). No impact of the perceived social support status on timely treatment initiation was found. The percentage of breast cancer patients waiting longer than 90 days from pathological diagnosis to systemic treatment initiation in Ethiopia remains unacceptably high. While women generally feel well supported by their social environment, costs and accessibility of treatment are perceived to be major barriers towards timely treatment initiation.Bethel TeshomeJosephin TrabitzschTsion AfeworkAdamu AddissieMirgissa KabaEva Johanna KantelhardtSefonias GetachewPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257163 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bethel Teshome Josephin Trabitzsch Tsion Afework Adamu Addissie Mirgissa Kaba Eva Johanna Kantelhardt Sefonias Getachew Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
description	Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiation intervals of breast cancer patients and quantified the impact of socio-demographic and clinical factors, perceived barriers, and the patients´ perceived social support status on timely systemic treatment initiation (chemotherapy or hormonal therapy). A structured questionnaire was designed based on Pechansky´s "Concept of Access". Applying simple and multivariate logistic regression we analysed the influence of patients´ characteristics as well as their perceived barriers on timely treatment initiation. We measured social support with the Multidimensional Score of Perceived Social Support (MSPSS) and used the Wilcoxon Rank-Sum Test to assess its relationship with timely treatment initiation. Of 196 patients included into the study, 53% received systemic treatment within 90 days of their pathological diagnosis-the median treatment initiation interval was 85 days (IQR 123.5). Older women and patients diagnosed at late stages had higher odds of timely treatment initiation. Not being able to pay for services and lack of transport were most often perceived as barriers towards timely care. However, none of the perceived barriers showed a substantial influence on timely treatment initiation in the multivariate regression model. The patients´ perceived social support was found to be high, with an average MSPSS score of 73 out of 84 (SD 13,63). No impact of the perceived social support status on timely treatment initiation was found. The percentage of breast cancer patients waiting longer than 90 days from pathological diagnosis to systemic treatment initiation in Ethiopia remains unacceptably high. While women generally feel well supported by their social environment, costs and accessibility of treatment are perceived to be major barriers towards timely treatment initiation.
format	article
author	Bethel Teshome Josephin Trabitzsch Tsion Afework Adamu Addissie Mirgissa Kaba Eva Johanna Kantelhardt Sefonias Getachew
author_facet	Bethel Teshome Josephin Trabitzsch Tsion Afework Adamu Addissie Mirgissa Kaba Eva Johanna Kantelhardt Sefonias Getachew
author_sort	Bethel Teshome
title	Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
title_short	Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
title_full	Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
title_fullStr	Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
title_full_unstemmed	Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.
title_sort	perceived barriers to timely treatment initiation and social support status among women with breast cancer in ethiopia.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/6f4e573169d148d8ac51df80a280b8fa
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Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia.

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