Pakistani healthcare professionals' perceptions of communication with patients and their relatives about hereditary breast cancer: a qualitative study in a LMIC.

IF 1.5 Q4 GENETICS & HEREDITY
Shenaz Ahmed, Hussain Jafri, Wajeeha Naseer Ahmed, Andleeb Khanam, Yasmin Rashid, Mushtaq Ahmed
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Abstract

Pakistan has the highest incidence and mortality rates of breast cancer in Asia, with high numbers of patients diagnosed at a young age suggesting the possibility of an inherited cancer syndrome. Communication of hereditary breast cancer (HBC) risk information with patients could enable earlier detection of the condition in relatives and reduce mortality rates. This study aimed to explore perceptions of healthcare professionals (HCPs) in Pakistan about communication with patients and their relatives about HBC. Semi-structured qualitative interviews were conducted with eighteen HCPs during March to May 2020 in Lahore. Thematic analysis shows the HCPs were generally supportive of informing patients themselves about HBC, but believed it was the patients' role to inform their relatives. HCPs also highlighted important barriers to communication with patients about HBC, including (i) patients' low socioeconomic status and educational attainment; (ii) high prevalence of the social stigma of breast cancer; and (iii) lack of health resources and facilities to provide genetic testing for HBC. In conclusion, HCPs would value the development of interventions to support communication between HCPs and patients. They also highlighted the need for interventions to support intrafamilial communication about HBC. Much research and political support are needed to address patient, social, and systemic-level barriers to facilitate communication about HBC.

巴基斯坦医疗保健专业人员对遗传性乳腺癌患者及其亲属沟通的看法:一项LMIC的定性研究
巴基斯坦是亚洲乳腺癌发病率和死亡率最高的国家,大量患者在年轻时被诊断出可能患有遗传性癌症综合症。与患者沟通遗传性乳腺癌(HBC)风险信息可以使亲属更早地发现该病并降低死亡率。本研究旨在探讨巴基斯坦卫生保健专业人员(HCPs)对与患者及其亲属沟通HBC的看法。2020年3月至5月在拉合尔对18名卫生保健人员进行了半结构化定性访谈。主题分析显示,HCPs普遍支持告知患者自己有关HBC的情况,但认为告知其亲属是患者的责任。HCPs还强调了与患者沟通HBC的重要障碍,包括(i)患者的低社会经济地位和受教育程度;(ii)社会对乳腺癌的耻辱感普遍存在;(三)缺乏提供HBC基因检测的卫生资源和设施。总之,医护人员将重视干预措施的发展,以支持医护人员与患者之间的沟通。他们还强调需要采取干预措施,以支持关于HBC的家庭内部沟通。需要大量的研究和政治支持来解决患者、社会和系统层面的障碍,以促进关于HBC的沟通。
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来源期刊
Journal of Community Genetics
Journal of Community Genetics GENETICS & HEREDITY-
CiteScore
3.30
自引率
5.30%
发文量
54
期刊介绍: The Journal of Community Genetics is an international forum for research in the ever-expanding field of community genetics, the art and science of applying medical genetics to human communities for the benefit of their individuals. Community genetics comprises all activities which identify persons at increased genetic risk and has an interest in assessing this risk, in order to enable those at risk to make informed decisions. Community genetics services thus encompass such activities as genetic screening, registration of genetic conditions in the population, routine preconceptional and prenatal genetic consultations, public education on genetic issues, and public debate on related ethical issues. The Journal of Community Genetics has a multidisciplinary scope. It covers medical genetics, epidemiology, genetics in primary care, public health aspects of genetics, and ethical, legal, social and economic issues. Its intention is to serve as a forum for community genetics worldwide, with a focus on low- and middle-income countries. The journal features original research papers, reviews, short communications, program reports, news, and correspondence. Program reports describe illustrative projects in the field of community genetics, e.g., design and progress of an educational program or the protocol and achievement of a gene bank. Case reports describing individual patients are not accepted.
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