Abstract PO5-10-09: Capturing Experiences: Navigating Breast Cancer Treatment of Nigerian Patients and Healthcare Providers Using Qualitative Interviews
Authors: Blessing Nwachukwu, Elizabeth Papautsky
Journal: Cancer Research (2024)

Abstract Introduction A notable shift has occurred in medical relationships, placing greater emphasis on the role of patients within the healthcare system. A nascent body of literature in the US captures the experiences of patients following a diagnosis, but this is lacking in Nigeria. We used Systems Engineering Initiative for Patient Safety (SEIPS 2.0) as a theoretical framework from the discipline of human factors that serves as a guide for characterizing complex sociotechnical systems comprised of factors, work processes, and outcomes - with the patient and clinicians at the center. We specifically focused on the patient work network, which refers to individuals and communities that play role in supporting patient work. The objective of this study was to elicit the experiences of Nigerian breast cancer patients and healthcare providers by qualitative interviews and characterize productive and counterproductive activities of the patient work network. Methods The study was approved by the IRB. We used snowball sampling and social media to recruit Nigerian breast cancer patients and health care providers with experience treating breast cancer. One researcher conducted interviews that lasted 30–60 min using teleconferencing technology and an interview guide developed for this study. Questions for both patients and healthcare providers covered topics such as patient response to diagnosis, barriers and facilitators to care including people and communities within the patient’s network. We calculated descriptive statistics for demographics. Using thematic analysis, we carried out the analysis in the following stages: data review, category coding and data extraction, and synthesis and integration of findings. Results We interviewed 18 female patients (29-67 yrs old) and 6 healthcare providers (31-42 yrs old; 3 males). Twelve patients received treatment in urban areas and 6 in rural. Four patients had a bachelor's degree. Healthcare providers included primary, specialty, palliative, treatment, diagnostic care. We highlight a subset of the dataset with focus on productive versus unproductive work conducted by family and by religious community, with unproductive defined as potentially having negative impact on the patient and their experience (Table 1). Providers stated that patients who receive family support exhibit better health outcomes compared to those who do not. Providers shared that religious community can perpetuate patient denial in their diagnosis. Both patients and providers discussed an inclination towards seeking traditional care. Despite recognizing the challenges and pressures faced by patients, providers lacked in-depth understanding of the specific experiences patients encountered. Conclusion Our findings highlight the role of family and religious community in conducting activities that are both productive and unproductive facilitating productive activities and its influence on the decision-making process of patients. Alternatively, both family and religious community engage in activities counterproductive to the patient and their illness. Findings emphasize the importance of comprehensive support systems, education, and targeted interventions to improve the experiences and outcomes of Nigerian breast cancer patients. Effective strategies should address cultural beliefs, empower patients to make informed decisions, and enhance provider knowledge regarding the unique challenges faced by patients within the identified barriers. Table. Productive versus unproductive work conducted by family and by religious community Citation Format: Blessing Nwachukwu, Elizabeth Papautsky. Capturing Experiences: Navigating Breast Cancer Treatment of Nigerian Patients and Healthcare Providers Using Qualitative Interviews [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-10-09.