Qualitative study to explore reasons for 'no-show' after diagnosis of breast cancer in a private teaching hospital in Kerala

Abstract

Background and objectives: Breast Cancer is the commonest cancer among women both in developed and developing world. Exploring the reasons involved in 'no-show' at the health facility, which is also a teaching hospital, after being diagnosed with breast cancer can aid as a problem identifier, act as an add-on for continuous quality improvement in healthcare and open avenue of understanding about participation that women have in decision-making. This study aims to explore the reasons for 'no-show' after diagnosis of breast cancer in a teaching hospital.

Method: A hospital-based cancer registry was used to extract the number of patients from the medical records department (MRD) who were diagnosed with breast cancer but did not show up for the treatment offered. Qualitative study method of in-depth interview was employed to understand the reasons for not following up after diagnosis. Interviews were audio taped, transcribed verbatim, analyzed for thematic contents using the standard content analysis framework.

Result: Personal, familial, social, and hospital-related factors were involved in not following up in the health facility. The major themes were financial difficulties, general inconvenience, others' decisions, alternative therapy, acclaimed oncologists, and awful occurrences, which were categorized under three heads as perceived barriers to continuing treatment in the health facility of study, perceived benefits of treatment in other facilities, and influence of family, friends, and society on decision-making.

Conclusion: The study throws light on the multitude of reasons behind 'no-show' behavior among patients with breast cancer from the facility where the diagnosis was made, highlighting the requirement for a more patient-centred approach that considers financial, social, and psychological factors in healthcare delivery. Addressing these barriers could significantly improve treatment adherence and outcomes in breast cancer care.

Keywords: Breast cancer; care approach; decision making; exploratory study; no show after diagnosis; patient behavior; qualitative research.

Figure 1

Patient flow chart